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Sample records for grafting employing cardiopulmonary

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

    Science.gov (United States)

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

    2013-01-01

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

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

    OpenAIRE

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

    2010-01-01

    INTRODUCTION: Having poor sleep quality is common among patients following cardiopulmonary artery bypass graft surgery. Pain, stress, anxiety and poor sleep quality may be improved by massage therapy. OBJECTIVE: This study evaluated whether massage therapy is an effective technique for improving sleep quality in patients following cardiopulmonary artery bypass graft surgery. METHOD: Participants included cardiopulmonary artery bypass graft surgery patients who were randomized into a control g...

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

    DEFF Research Database (Denmark)

    Hillerup, Soren; Elberg, Jens Jorgen

    2014-01-01

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

  4. Fluid distribution kinetics during cardiopulmonary bypass

    Scientific Electronic Library Online (English)

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

    2014-08-01

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

  5. Complications of cardiopulmonary resuscitation

    OpenAIRE

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

    2010-01-01

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

  6. Teaching schoolchildren cardiopulmonary resuscitation.

    Science.gov (United States)

    Lester, C; Donnelly, P; Weston, C; Morgan, M

    1996-02-01

    Forty-one children aged 11-12 years received tuition in cardiopulmonary resuscitation (CPR) and subsequently completed questionnaires to assess their theoretical knowledge and attitudes their likelihood of performing CPR. Although most children scored well on theoretical knowledge, this did not correlate with an assessment of practical ability using training manikins. In particular only one child correctly called for help after the casualty was found to be unresponsive, and none telephoned for an ambulance before starting resuscitation. These omissions have important implications for the teaching of CPR and the resulting effectiveness of community CPR programmes. PMID:8701107

  7. Cardiopulmonary bypass in pregnancy

    Directory of Open Access Journals (Sweden)

    Mukul Chandra Kapoor

    2014-01-01

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

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

    Scientific Electronic Library Online (English)

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

    2014-12-01

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

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

    Scientific Electronic Library Online (English)

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

    2009-03-01

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

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

    Directory of Open Access Journals (Sweden)

    Ricardo de Carvalho Lima

    2003-09-01

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

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

    Scientific Electronic Library Online (English)

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

    2003-09-01

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

  12. A Reappraisal of Saphenous Vein Grafting

    OpenAIRE

    Yuan Shi-Min; Jing Hua

    2011-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Ricardo Antonio G. Barbosa

    2009-03-01

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

  14. Plant grafting.

    Science.gov (United States)

    Melnyk, Charles W; Meyerowitz, Elliot M

    2015-03-01

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

  15. Palliative care in cardiopulmonary transplantation.

    Science.gov (United States)

    McKenna, Maria; Clark, Stephen C

    2015-12-01

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

  16. 21 CFR 870.4280 - Cardiopulmonary prebypass filter.

    Science.gov (United States)

    2010-04-01

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

  17. 21 CFR 870.4400 - Cardiopulmonary bypass blood reservoir.

    Science.gov (United States)

    2010-04-01

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

  18. MRI Catheterization in Cardiopulmonary Disease

    OpenAIRE

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

    2014-01-01

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

  19. Modeling mechanical cardiopulmonary interactions for virtual environments.

    OpenAIRE

    Kaye, J. M.

    1997-01-01

    We have developed a computer system for modeling mechanical cardiopulmonary behavior in an interactive, 3D virtual environment. The system consists of a compact, scalar description of cardiopulmonary mechanics, with an emphasis on respiratory mechanics, that drives deformable 3D anatomy to simulate mechanical behaviors of and interactions between physiological systems. Such an environment can be used to facilitate exploration of cardiopulmonary physiology, particularly in situations that are ...

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

    Science.gov (United States)

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

    2003-06-01

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

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

    DEFF Research Database (Denmark)

    Møller, Christian H; Steinbrüchel, Daniel A

    2014-01-01

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

  2. Grafting efficiency of synthetic polymers onto biomaterials: a comparative study of grafting-from versus grafting-to.

    Science.gov (United States)

    Hansson, Susanne; Trouillet, Vanessa; Tischer, Thomas; Goldmann, Anja S; Carlmark, Anna; Barner-Kowollik, Christopher; Malmström, Eva

    2013-01-14

    In the present study, the two grafting techniques grafting-from - by activators regenerated by electron transfer atom transfer radical polymerization (ARGET ATRP) - and grafting-to - by copper(I)-catalyzed azide-alkyne cycloaddition (CuAAC) - were systematically compared, employing cellulose as a substrate. In order to obtain a meaningful comparison, it is crucial that the graft lengths of the polymers that are grafted from and to the substrates are essentially identical. Herein, this was achieved by utilizing the free polymer formed in parallel to the grafting-from reaction as the polymer for the grafting-to reaction. Four graft lengths were investigated, and the molar masses of the four free polymers (21 ? M(n) ? 100 kDa; 1.07 ? ?(M) ? 1.26), i.e. the polymers subsequently employed in the grafting-to reaction, were shown to be in the same range as the molar masses of the polymers grafted from the surface (23 ? M(n) ? 87 kDa; 1.08 ? ?(M) ? 1.31). The molecular weights of the chains grafted from the surface were established after cleavage from the cellulose substrates via size exclusion chromatography (SEC). High-resolution Fourier transform infrared microscopy (FT-IRM) was employed as an efficient tool to study the spatial distribution of the polymer content on the grafted substrates. In addition, the functionalized substrates were analyzed by X-ray photoelectron spectroscopy (XPS), contact angle (CA) measurements, and field-emission scanning electron microscopy (FE-SEM). For cellulose substrates modified via the grafting-from approach, the content of polymer on the surfaces increased with increasing graft length, confirming the possibility to tailor not only the length of the polymer grafts but also the polymeric content on the surface. In comparison, for the grafting-to reaction, the grafted content could not be controlled by varying the length of the preformed polymer: the polymer content was essentially the same for the four graft lengths. Consequently, the obtained results, when employing cellulose as a substrate and under these conditions, suggest that the grafting-from approach is superior to the grafting-to technique with respect to controlling the distribution of the polymeric content on the surface. PMID:23043441

  3. Cardiopulmonary loading in motocross riding.

    Science.gov (United States)

    Konttinen, Tomi; Häkkinen, Keijo; Kyröläinen, Heikki

    2007-07-01

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

  4. Pulmonary complications of cardiopulmonary bypass.

    Science.gov (United States)

    Huffmyer, Julie L; Groves, Danja S

    2015-06-01

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

  5. Cardiopulmonary helminths in foxes from the Pyrenees.

    Science.gov (United States)

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

    2015-12-01

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

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

    DEFF Research Database (Denmark)

    MØller, Christian H; Jensen, Birte Østergaard

    2007-01-01

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

  7. Brain microvascular function during cardiopulmonary bypass

    DEFF Research Database (Denmark)

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

    1987-01-01

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

  8. Evaluation of olfactory memory after coronary artery bypass grafting

    Science.gov (United States)

    Yurttas, Veysel; Bilgi, Murat; Dem?rhan, Abdullah; Apuhan, Tayfun; Bugra, Onursal; Daglar, Bahadir

    2014-01-01

    Introduction This study determined whether coronary artery bypass grafting (CABG) surgery has any effect on olfactory function, employing the Brief Smell Identification Test (B-SIT). Material and methods All the participants were informed preoperatively about the B-SIT test and the mode of its application. The test was performed by each patient preoperatively (d0) as well as 1 (d1) and 3 (d3) days following the surgery. C-reactive protein (CRP) levels were recorded at the same time as the smell test. Results This prospective study included 45 patients. The mean age was 67 ± 7.55, and the group was 29% male. The mean durations of cross clamping and cardiopulmonary bypass were 54 ± 32 min and 62.5 ± 37.0 min, respectively. Eleven different odors were tested. Significant differences were observed for several odors: leather between d0 and d3, pine between d0 and d3, onion between d0 and d1, onion between d0 and d3, and soap between d0 and d1. The postoperative CRP levels were significantly higher than the preoperative levels. The correlation analysis determined that the postoperative CRP levels were negatively correlated with the B-SIT score (r = –0.48, p = 0.001). Conclusions Our findings suggest that patients after CABG are prone to develop olfactory dysfunction in the early postoperative period and that olfactory dysfunction is associated with postoperative CRP levels. PMID:26336453

  9. Aortic reconstruction with bovine pericardial grafts

    Directory of Open Access Journals (Sweden)

    Silveira Lindemberg Mota

    2003-01-01

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

  10. Cardiopulmonary resuscitation: a new perspective

    Directory of Open Access Journals (Sweden)

    V. A. Sulimov

    2012-01-01

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

  11. Smoking cessation in patients with cardiopulmonary diseases

    Directory of Open Access Journals (Sweden)

    Zeynep P?nar Önen

    2011-05-01

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

  12. Stent graft placement for dysfunctional arteriovenous grafts

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-07-15

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

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

    Directory of Open Access Journals (Sweden)

    Flavia Baggio Nerbass

    2010-01-01

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

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

    Scientific Electronic Library Online (English)

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

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

  15. Polystyrene modified by grafting

    Scientific Electronic Library Online (English)

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

    1997-06-01

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

  16. History of the evolution of cardiopulmonary resuscitation

    Directory of Open Access Journals (Sweden)

    George Karlis

    2013-04-01

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

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

    Science.gov (United States)

    Madrid, Jordan F.; Abad, Lucille V.

    2015-10-01

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

  18. Diabetic patients have abnormal cerebral autoregulation during cardiopulmonary bypass

    International Nuclear Information System (INIS)

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

  19. Emergent cardiopulmonary bypass during pectus excavatum repair

    Directory of Open Access Journals (Sweden)

    Ryan Craner

    2013-01-01

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

  20. 21 CFR 870.4220 - Cardiopulmonary bypass heart-lung machine console.

    Science.gov (United States)

    2010-04-01

    ...Cardiopulmonary bypass heart-lung machine console. 870.4220 Section 870...Cardiopulmonary bypass heart-lung machine console. (a) Identification. A cardiopulmonary bypass heart-lung machine console is a device that...

  1. 21 CFR 870.4260 - Cardiopulmonary bypass arterial line blood filter.

    Science.gov (United States)

    2010-04-01

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

  2. 21 CFR 870.4270 - Cardiopulmonary bypass cardiotomy suction line blood filter.

    Science.gov (United States)

    2010-04-01

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

  3. 21 CFR 870.4410 - Cardiopulmonary bypass in-line blood gas sensor.

    Science.gov (United States)

    2010-04-01

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

  4. Haemodialysis and haemofiltration on cardiopulmonary bypass.

    OpenAIRE

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

    1985-01-01

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

  5. Assessing Exercise Limitation Using Cardiopulmonary Exercise Testing

    OpenAIRE

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

    2012-01-01

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

  6. Artificial neural network cardiopulmonary modeling and diagnosis

    Science.gov (United States)

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

    1997-10-28

    The present invention is a method of diagnosing a cardiopulmonary condition in an individual by comparing data from a progressive multi-stage test for the individual to a non-linear multi-variate model, preferably a recurrent artificial neural network having sensor fusion. The present invention relies on a cardiovascular model developed from physiological measurements of an individual. Any differences between the modeled parameters and the parameters of an individual at a given time are used for diagnosis. 12 figs.

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

    DEFF Research Database (Denmark)

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

    2015-01-01

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

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

    OpenAIRE

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

    1995-01-01

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

  9. 21 CFR 870.4230 - Cardiopulmonary bypass defoamer.

    Science.gov (United States)

    2010-04-01

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

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

    DEFF Research Database (Denmark)

    Witting, N; Mensah, A; Køber, L; Bundgaard, H; Petri, H; Duno, M; Milea, D; Vissing, J

    2014-01-01

    OBJECTIVES: To assess skeletal muscle weakness and progression as well as the cardiopulmonary involvement in oculopharyngeal muscular dystrophy (OPMD). MATERIALS AND METHODS: Cross-sectional study including symptomatic patients with genetically confirmed OPMD. Patients were assessed by medical history, ptosis, ophthalmoplegia, facial and limb strength, and swallowing capability. Cardiopulmonary function was evaluated using forced expiratory capacity in 1 s (FEV1), electrocardiogram (ECG), Holter...

  11. 21 CFR 870.4280 - Cardiopulmonary prebypass filter.

    Science.gov (United States)

    2010-04-01

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

  12. 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

  13. Endovascular stent-graft management of thoracic aortic diseases

    International Nuclear Information System (INIS)

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

  14. Endovascular stent-graft management of thoracic aortic diseases

    Energy Technology Data Exchange (ETDEWEB)

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

    2001-07-01

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

  15. The radiation-induced grafting of polybutadiene onto silica

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-07-15

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

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

    DEFF Research Database (Denmark)

    Yamauchi, Yasushi; Yamashita, Yuichi

    2006-01-01

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

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

    Scientific Electronic Library Online (English)

    Hermes, Ilarraza-Lomelí.

    2012-06-01

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

  18. A reappraisal of saphenous vein grafting

    Directory of Open Access Journals (Sweden)

    Yuan Shi-Min

    2011-01-01

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

  19. Strategies for cardiopulmonary exercise testing of pectus excavatum patients

    Scientific Electronic Library Online (English)

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

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

  20. The teaching of cardiopulmonary resuscitation in schools in Hampshire.

    Science.gov (United States)

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

    1997-08-01

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

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

    International Nuclear Information System (INIS)

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

  2. Necessity of immediate cardiopulmonary resuscitation in trauma emergency

    OpenAIRE

    Luciano Baitello; Marcela Gonzáles; Cesar Espada; Godoy José

    2010-01-01

    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. Patie...

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

    OpenAIRE

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

    1985-01-01

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

  4. Effect of Saral meditation on intelligence, performance and cardiopulmonary functions.

    Science.gov (United States)

    Shah, A H; Joshi, S V; Mehrotra, P P; Potdar, N; Dhar, H L

    2001-11-01

    Meditation is a mental exercise to improve mental faculty. Present attempt was to evaluate effect of Saral Meditation on development of intelligence, academic performance & cardiopulmonary functions. Results show significant improvement in development of intelligence and academic performance. There was apparent improvement in confidence and they were free from anxiety. There were also considerable changes in psychomotor ability and cardiopulmonary functions however, result was not significant. PMID:12508633

  5. Acute Cardiopulmonary Failure From Sleep-Disordered Breathing

    OpenAIRE

    Carr, Gordon E.; Mokhlesi, Babak; Gehlbach, Brian K.

    2012-01-01

    Sleep-disordered breathing (SDB) comprises a diverse set of disorders marked by abnormal respiration during sleep. Clinicians should realize that SDB may present as acute cardiopulmonary failure in susceptible patients. In this review, we discuss three clinical phenotypes of acute cardiopulmonary failure from SDB: acute ventilatory failure, acute congestive heart failure, and sudden death. We review the pathophysiologic mechanisms and recommend general principles for management. Timely recogn...

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

    DEFF Research Database (Denmark)

    Heine, Martin; Wens, Inez

    2015-01-01

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

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

    International Nuclear Information System (INIS)

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

  8. Outcome of cardiopulmonary resuscitation - predictors of survival

    International Nuclear Information System (INIS)

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

  9. Cardiopulmonary Exercise Testing in Heart Failure.

    Science.gov (United States)

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

    2015-08-01

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

  10. Conflicting perspectives compromising discussions on cardiopulmonary resuscitation.

    LENUS (Irish Health Repository)

    Groarke, J

    2010-09-01

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

  11. Historical development of the cardiopulmonary ressuscitation: review study

    Directory of Open Access Journals (Sweden)

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

    2009-07-01

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

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

    OpenAIRE

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

    1995-01-01

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

  13. 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

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

    Science.gov (United States)

    2010-04-01

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

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

    Directory of Open Access Journals (Sweden)

    Demetra S. Achilleos

    2010-03-01

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

  16. A Review of Carbon Dioxide Monitoring During Adult Cardiopulmonary Resuscitation.

    Science.gov (United States)

    Pantazopoulos, Charalampos; Xanthos, Theodoros; Pantazopoulos, Ioannis; Papalois, Apostolos; Kouskouni, Evangelia; Iacovidou, Nicoletta

    2015-11-01

    Although high quality cardiopulmonary resuscitation is one of the most significant factors related to favourable outcome, its quality depends on many components, such as airway management, compression depth and chest recoil, hands-off time, and early defibrillation. The most common way of controlling the resuscitation efforts is monitoring of end-tidal carbon dioxide. The International Liaison Committee on Resuscitation suggests this method both for in-hospital and out-of-hospital cardiac arrest. However, despite the abundant human and animal studies supporting the usefulness of end-tidal carbon dioxide, its optimal values during cardiopulmonary resuscitation remain controversial. In this review, the advantages and effectiveness of end-tidal carbon dioxide during cardiopulmonary resuscitation are discussed and specific target values are suggested based on the available literature. PMID:26150002

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

    Science.gov (United States)

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

    2011-03-22

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

  18. 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.)

  19. Synchronization and Cardio-pulmonary feedback in Sleep Apnea

    Science.gov (United States)

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

    2004-03-01

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

  20. Bone Graft Alternatives

    Science.gov (United States)

    ... graft that comes from a donor is called allograft bone . Allograft bone usually comes from bone banks that harvest the bone from cadavers. The types of allograft bone used for spine surgery include fresh frozen and ...

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

    Directory of Open Access Journals (Sweden)

    Yoshihiro Moriwaki

    2012-01-01

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

  2. Left ventricular assist device outflow graft: alternative sites

    OpenAIRE

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

    2014-01-01

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

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

    International Nuclear Information System (INIS)

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

  4. Necessity of immediate cardiopulmonary resuscitation in trauma emergency

    Directory of Open Access Journals (Sweden)

    Luciano Baitello

    2010-08-01

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

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

    Science.gov (United States)

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

    2010-01-01

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

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

    Scientific Electronic Library Online (English)

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

    2005-05-01

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

  7. The significance of graft diameter.

    Science.gov (United States)

    Sanders, R J; Kempczinski, R F; Hammond, W; DiClementi, D

    1980-12-01

    To study the influence of diameter on graft patency, an 8 mm aortoiiliac Dacron graft was implanted in on leg of 25 dogs that had liac arteries 3 to 5 mm in diameter and a 5 mm graft was placed in the other leg. In six dogs both grafts clotted within 3 months, in 10 dogs both grafts remained patient until the dogs were killed between 7 and 66 months, and in nine dogs one graft became occluded before the other. In eight of these nine animals the 8 mm graft became occluded before the 5 mm graft; only in one dog did the 5 mm graft become occluded first. When the 10 dogs with two patient grafts were killed, the 8 mm graft was found to be lined with thick, organized fibrin, whereas the 5 mm graft had a thin, smooth, glistening lining. Histologic examination confirmed that healing was more complete in the 5 mm graft. In vivo blood flow measurements in the dogs were used to compare flow rates and graft resistance in 4, 6, 8, 10, and 12 mm grafts. A given sized graft carried the same flow capacity as larger grafts until the flow rate was reached when graft resistance developed. Once resistance appeared, the graft could still triple or quadruple its flow capacity but it could not deliver the same rate of flow under the same pressure head as larger grafts. In 4 mm grafts, resistance first appeared at approximately 150 cc/min and capacity was 450 cc. In 6 mm grafts, resistance developed at 400 cc/min and capacity exceeded 1,200 cc. In 8 and 10 mm grafts, resistance was first noted at 800 and 1.400 cc/min, respectively. These studies suggest that 6 mm diameter grafts can carry the 200 cc/min or less that is measured in the human superficial femoral artery at rest, as well as the four-to sixfold increase that accompanies vigorous exercise. PMID:7444766

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

    Directory of Open Access Journals (Sweden)

    Schmidt Thomas

    2009-07-01

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

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

    Science.gov (United States)

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

    2009-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  11. Axillobifemoral bypass grafting

    Directory of Open Access Journals (Sweden)

    Davidovi? Lazar B.

    2004-01-01

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

  12. Crosslinked grafted PVC obtained by direct radiation grafting

    International Nuclear Information System (INIS)

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

  13. Epoxy and Silicone Optical Nanocomposites Filled with Grafted Nanoparticles

    Science.gov (United States)

    Tao, Peng

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

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

    DEFF Research Database (Denmark)

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

    2009-01-01

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

  15. Spinal bone graft - series (image)

    Science.gov (United States)

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

  16. Grafts for Ridge Preservation.

    Science.gov (United States)

    Jamjoom, Amal; Cohen, Robert E

    2015-01-01

    Alveolar ridge bone resorption is a biologic phenomenon that occurs following tooth extraction and cannot be prevented. This paper reviews the vertical and horizontal ridge dimensional changes that are associated with tooth extraction. It also provides an overview of the advantages of ridge preservation as well as grafting materials. A Medline search among English language papers was performed in March 2015 using alveolar ridge preservation, ridge augmentation, and various graft types as search terms. Additional papers were considered following the preliminary review of the initial search that were relevant to alveolar ridge preservation. The literature suggests that ridge preservation methods and augmentation techniques are available to minimize and restore available bone. Numerous grafting materials, such as autografts, allografts, xenografts, and alloplasts, currently are used for ridge preservation. Other materials, such as growth factors, also can be used to enhance biologic outcome. PMID:26262646

  17. Experience of ECMO in Primary Graft Dysfunction after Orthotopic Heart Transplantation

    Science.gov (United States)

    Lima, Elson Borges; da Cunha, Claudio Ribeiro; Barzilai, Vitor Salvatore; Ulhoa, Marcelo Botelho; de Barros, Maria Regina; Moraes, Camila Scatolin; Fortaleza, Letycia Chagas; Vieira, Nubia Wellerson; Atik, Fernando Antibas

    2015-01-01

    Background Primary graft dysfunction is the main cause of early mortality after heart transplantation. Mechanical circulatory support has been used to treat this syndrome. Objective Describe the experience with extracorporeal membrane oxygenation to treat post-transplant primary cardiac graft dysfunction. Methods Between January 2007 and December 2013, a total of 71 orthotopic heart transplantations were performed in patients with advanced heart failure. Eleven (15.5%) of these patients who presented primary graft dysfunction constituted the population of this study. Primary graft dysfunction manifested in our population as failure to wean from cardiopulmonary bypass in six (54.5%) patients, severe hemodynamic instability in the immediate postoperative period with severe cardiac dysfunction in three (27.3%), and cardiac arrest (18.2%). The average ischemia time was 151 ± 82 minutes. Once the diagnosis of primary graft dysfunction was established, we installed a mechanical circulatory support to stabilize the severe hemodynamic condition of the patients and followed their progression longitudinally. Results The average duration of extracorporeal membrane oxygenation support was 76 ± 47.4 hours (range 32 to 144 hours). Weaning with cardiac recovery was successful in nine (81.8%) patients. However, two patients who presented cardiac recovery did not survive to hospital discharge. Conclusion Mechanical circulatory support with central extracorporeal membrane oxygenation promoted cardiac recovery within a few days in most patients. PMID:26200896

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

    OpenAIRE

    Lemp, M A

    1989-01-01

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

  19. New membranes obtained by grafted irradiated PVDF foils

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-09-15

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

  20. Acrylonitrile grafted to PVDF

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Jin; Eitouni, Hany Basam

    2015-03-31

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

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

    International Nuclear Information System (INIS)

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

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

    Directory of Open Access Journals (Sweden)

    Yaghoobi Notash Ali

    2011-01-01

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

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

    Science.gov (United States)

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

    1983-08-23

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

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

    OpenAIRE

    Morgan, R; Westmoreland, C

    2002-01-01

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

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

    OpenAIRE

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

    2012-01-01

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

  6. Cardiopulmonary resuscitation : state of the art in 2011

    OpenAIRE

    Mohr, D

    2011-01-01

    Failure to recognise the signs of sudden cardiac arrest or impending cardiac arrest will lead to delayed intervention. Cardiopulmonary resuscitation (CPR) must be initiated without delay, irrespective of the level of skill of the caregiver. The 2010 CPR guidelines emphasise the importance of chest compressions, which have now become the first step in the CPR sequence [compressions, airway, breathing or circulation, airway, breathing (CAB), instead of airway, breathing, compression...

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

    OpenAIRE

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

    2013-01-01

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

  8. Withdrawing versus not offering cardiopulmonary resuscitation: Is there a difference?

    OpenAIRE

    Oczkowski, Simon JW; Rochwerg, Bram; Sawchuk, Corey

    2015-01-01

    Conflict between substitute decision makers (SDMs) and health care providers in the intensive care unit is commonly related to goals of treatment at the end of life. Based on recent court decisions, even medical consensus that ongoing treatment is not clinically indicated cannot justify withdrawal of mechanical ventilation without consent from the SDM. Cardiopulmonary resuscitation (CPR), similar to mechanical ventilation, is a life-sustaining therapy that can result in disagreement between S...

  9. Effects of inosine on reperfusion injury after cardiopulmonary bypass

    OpenAIRE

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

    2010-01-01

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

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

    OpenAIRE

    Davies, J. M.; Reynolds, B M

    1992-01-01

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

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

    DEFF Research Database (Denmark)

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

    2004-01-01

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

  12. Does tranexamic acid decrease bleeding in patients undergoing cardiopulmonary bypass?

    OpenAIRE

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

    1994-01-01

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

  13. Cardiopulmonary Exercise Testing in Lung Transplantation: A Review

    OpenAIRE

    Dudley, Katherine A.; Souheil El-Chemaly

    2012-01-01

    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...

  14. Tomographic ventilation-perfusion lung scintigraphy in cardiopulmonary disease

    OpenAIRE

    Jögi, Jonas

    2011-01-01

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

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

    OpenAIRE

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

    1982-01-01

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

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

    Science.gov (United States)

    Flannery, Alexander H; Parli, Sara E

    2016-01-01

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

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

    International Nuclear Information System (INIS)

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

  18. Cardiopulmonary function and scoliosis severity in idiopathic scoliosis children

    Science.gov (United States)

    Huh, Seokwon; Kim, Nam Kyun; Jung, Jo Won; Choi, Jae Young; Kim, Hak Sun

    2015-01-01

    Purpose Idiopathic scoliosis is a structural lateral curvature of the spine of unknown etiology. The relationship between degree of spine curvature and cardiopulmonary function has not yet been investigated. The purpose of this study was to determine the association between scoliosis and cardiopulmonary characteristics. Methods Ninety children who underwent preoperative pulmonary or cardiac evaluation at a single spine institution over 41 months were included. They were divided into the thoracic-dominant scoliosis (group A, n=78) and lumbar-dominant scoliosis (group B, n=12) groups. Scoliosis severity was evaluated using the Cobb method. In each group, relationships between Cobb angles and cardiopulmonary markers such as forced vital capacity (FVC), forced expiratory volume in one second (FEV1), FEV1/FVC, left ventricular ejection fraction, pulmonary artery flow velocity, and tissue Doppler velocities (E/E', E'/A') were analyzed by correlation analysis linear regression. Results In group A, 72 patients (92.3%) underwent pulmonary function tests (PFTs), and 41 (52.6%) underwent echocardiography. In group B, 9 patients (75.0%) underwent PFT and 8 (66.7%) underwent echocardiography. Cobb angles showed a significant negative correlation with FVC and FEV1 in group A (both Pscoliosis in patients with thoracic-dominant scoliosis. Myocardial diastolic function might be impaired in patients with the most severe scoliosis. PMID:26213550

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

    Scientific Electronic Library Online (English)

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

    2003-08-01

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

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

    Directory of Open Access Journals (Sweden)

    Barrios Ysamar

    2007-04-01

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

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

    Directory of Open Access Journals (Sweden)

    Poswal P

    2004-01-01

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

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

    Directory of Open Access Journals (Sweden)

    M.J.C. Carmona

    2005-05-01

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

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

    International Nuclear Information System (INIS)

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

  4. Are the additional grafts necessary?

    Directory of Open Access Journals (Sweden)

    ?ur?i? A.

    2010-01-01

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

  5. Coxiella burnetii vascular graft infection

    OpenAIRE

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

    2005-01-01

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

  6. Employment Outlook

    Science.gov (United States)

    Henderson, Bonnie C.

    1973-01-01

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

  7. 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)

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

    Science.gov (United States)

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

    2006-01-01

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

  9. 21 CFR 870.4270 - Cardiopulmonary bypass cardiotomy suction line blood filter.

    Science.gov (United States)

    2010-04-01

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

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

    OpenAIRE

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

    1986-01-01

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

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

    OpenAIRE

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

    2011-01-01

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

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

    Directory of Open Access Journals (Sweden)

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Sergio Nunes Pereira

    2015-08-01

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

  14. Coxiella burnetii vascular graft infection

    Directory of Open Access Journals (Sweden)

    Von Segesser Ludwig

    2005-12-01

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

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

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

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

    2014-08-01

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

  17. Home-based mobile cardio-pulmonary rehabilitation consultant system.

    Science.gov (United States)

    Lee, Hsu-En; Wang, Wen-Chih; Lu, Shao-Wei; Wu, Bo-Yuan; Ko, Li-Wei

    2011-01-01

    Cardiovascular diseases are the most popular cause of death in the world recently. For postoperatives, cardiac rehabilitation is still asked to maintain at home (phase II) to improve cardiac function. However, only one third of outpatients do the exercise regularly, reflecting the difficulty for home-based healthcare: lacking of monitoring and motivation. Hence, a cardio-pulmonary rehabilitation system was proposed in this research to improve rehabilitation efficiency for better prognosis. The proposed system was built on mobile phone and receiving electrocardiograph (ECG) signal from a wireless ECG holter via Bluetooth connection. Apart from heart rate (HR) monitor, an ECG derived respiration (EDR) technique is also included to provide respiration rate (RR). Both HR and RR are the most important vital signs during exercise but only used one physiological signal recorder in this system. In clinical test, there were 15 subjects affording Bruce Task (treadmill) to simulate rehabilitation procedure. Correlation between this system and commercial product (Custo-Med) was up to 98% in HR and 81% in RR. Considering the prevention of sudden heart attack, an arrhythmia detection expert system and healthcare server at the backend were also integrated to this system for comprehensive cardio-pulmonary monitoring whenever and wherever doing the exercise. PMID:22254478

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

    DEFF Research Database (Denmark)

    Witting, N; Mensah, A

    2014-01-01

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

  19. Effects of inosine on reperfusion injury after cardiopulmonary bypass

    Directory of Open Access Journals (Sweden)

    Horkay Ferenc

    2010-11-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2003-03-01

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

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

    International Nuclear Information System (INIS)

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

  2. Industry Employment

    Science.gov (United States)

    Occupational Outlook Quarterly, 2012

    2012-01-01

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

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

    Scientific Electronic Library Online (English)

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

    2009-09-01

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

  4. Modification of synthetic fibers by radiation-induced grafting

    International Nuclear Information System (INIS)

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

  5. 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)

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

    Science.gov (United States)

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

    2015-10-01

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

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

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

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

    2001-01-01

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

  9. Supported Employment

    OpenAIRE

    Jordán de Urríes, Francisco de Borja

    2010-01-01

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

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

    International Nuclear Information System (INIS)

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

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

    Directory of Open Access Journals (Sweden)

    Wohlfart Björn

    2010-10-01

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

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

    Directory of Open Access Journals (Sweden)

    M. PGoranaraki

    1998-04-01

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

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

    Science.gov (United States)

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

    2014-09-01

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

  14. Coronary blood flow during cardiopulmonary resuscitation in swine

    International Nuclear Information System (INIS)

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

  15. Controlled grafting of cellulose diacetate.

    Czech Academy of Sciences Publication Activity Database

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

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

  16. Coronary arteries bypass grafting stenosis

    Directory of Open Access Journals (Sweden)

    Mahmoud Ebrahimi

    2014-12-01

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

  17. ACL Reconstruction: Choosing the Graft

    OpenAIRE

    CERULLI, GIULIANO; Placella, Giacomo; Sebastiani, Enrico; Tei, Matteo Maria; Speziali, Andrea; Manfreda, Francesco

    2013-01-01

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

  18. Vascular graft infections with Mycoplasma

    DEFF Research Database (Denmark)

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

    1995-01-01

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

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

    Data.gov (United States)

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

  20. Preliminary Development and Validation of a Paediatric Cardiopulmonary Physiotherapy Discharge Tool

    OpenAIRE

    Ellerton, Cindy; Davis, Aileen; Brooks, Dina

    2011-01-01

    Purpose: The purpose of this study was to develop a paediatric cardiopulmonary physiotherapy (CPT) discharge tool. We report on the initial stages of its development and the tool's sensibility (face/content validity, feasibility, and ease of usage).

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

    LENUS (Irish Health Repository)

    Cotter, P E

    2009-03-01

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

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

    LENUS (Irish Health Repository)

    Marshall, C

    2012-02-03

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

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

    OpenAIRE

    Suat Zengin; Cuma Y?ld?r?m; Behçet Al; Sinan Genç; Hasan K?l?ç; Mehmet Do?an

    2012-01-01

    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 th...

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

    OpenAIRE

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

    2015-01-01

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

  5. Anterior Cruciate Ligament Reconstruction: Clinical Outcomes of Patella Tendon and Hamstring Tendon Grafts

    OpenAIRE

    Gulick, Dawn T.; Yoder, Heather N.

    2002-01-01

    An injury to the ACL can result in significant functional impairment. It has been estimated that more than 100,000 new ACL injuries occur each year. Surgeons employ numerous techniques for reconstruction of the ACL. Of critical importance is the source of the graft to replace the damaged ACL. The graft choices include autografts (the patient's own tissue), allografts (donor tendon), and synthetic/prosthetic ligaments. Tissue harvest sites for autografting include the middle third of the patel...

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

    DEFF Research Database (Denmark)

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

    2014-01-01

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

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

    OpenAIRE

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

    2014-01-01

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

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

    International Nuclear Information System (INIS)

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

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

    LENUS (Irish Health Repository)

    Coleman, E T

    2012-02-03

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

  10. Surface-grafted polymers from electrodeposited macroprecursors

    Science.gov (United States)

    Rellamas Tria, Maria Celeste

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

  11. The effects of tranexamic acid and 6% hydroxyethyl starch (HES) solution (130/0.4) on postoperative bleeding in coronary artery bypass graft (CABG) surgery

    OpenAIRE

    Yanartas, M; Baysal, A., ?.; Ayd?n, C; Ay, Y; Kara, ?; Ayd?n, E.; Cevirme, D; Köksal, C; SUNAR, H.

    2015-01-01

    Background: The addition of 6% hydroxyethyl starch (HES) into Ringer lactate priming solution may have adverse effects on hemostasis in patients undergoing coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB) with or without the use of tranexamic acid. Methods: In a prospective, randomized clinical trial, 132 patients were assigned to receive 20 ml/kg of Ringer priming solution with or without tranexamic acid (TA) (Group RS-TA, n=34 and Group RS-noTA, n=32) or 10 ml/kg of ...

  12. Plant grafting: new mechanisms, evolutionary implications.

    Science.gov (United States)

    Goldschmidt, Eliezer E

    2014-01-01

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

  13. Northern employment

    International Nuclear Information System (INIS)

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

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

    LENUS (Irish Health Repository)

    Flynn, Michael J

    2012-02-03

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

  15. Quantification of cardiopulmonary blood volume turnover using dynamic PET

    DEFF Research Database (Denmark)

    Harms, Hans; Tolbod, Lars Poulsen

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

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

    Directory of Open Access Journals (Sweden)

    Jasmin Caluk

    2008-06-01

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

  17. Radiation grafting of acrylamide onto polystyrene beads

    International Nuclear Information System (INIS)

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

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

    DEFF Research Database (Denmark)

    Chernyy, Sergey; Bousquet, Antoine

    2012-01-01

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

  19. Graft healing in anterior cruciate ligament reconstruction

    OpenAIRE

    Chen Chih-Hwa

    2009-01-01

    Abstract Successful anterior cruciate ligament reconstruction with a tendon graft necessitates solid healing of the tendon graft in the bone tunnel. Improvement of graft healing to bone is crucial for facilitating an early and aggressive rehabilitation and ensuring rapid return to pre-injury levels activity. Tendon graft healing in a bone tunnel requires bone ingrowth into the tendon. Indirect Sharpey fiber formation and direct fibrocartilage fixation confer different anchorage strength and i...

  20. Primary Breast Augmentation with Fat Grafting.

    Science.gov (United States)

    Coleman, Sydney R; Saboeiro, Alesia P

    2015-07-01

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

  1. Vascular Grafting Strategies in Coronary Intervention

    OpenAIRE

    Knight, Darryl K.; Gillies, Elizabeth R.; Mequanint, Kibret

    2014-01-01

    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 ...

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

    Scientific Electronic Library Online (English)

    Lakshmi, Rajeswaran; Valerie J., Ehlers.

    2014-01-01

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

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

    International Nuclear Information System (INIS)

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

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

    Directory of Open Access Journals (Sweden)

    Bhavani Shankar Kodali

    2014-01-01

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

  5. Acute mesenteric ischemia after cardio-pulmonary bypass surgery

    Directory of Open Access Journals (Sweden)

    Bassam Abboud, Ronald Daher, Joe Boujaoude

    2008-09-01

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

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

    Science.gov (United States)

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

    2014-11-01

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

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

    Science.gov (United States)

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

    2010-11-01

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

  8. Costal Cartilage Grafts in Rhinoplasty.

    Science.gov (United States)

    Fedok, Fred G

    2016-01-01

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

  9. 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

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

    Directory of Open Access Journals (Sweden)

    Dawn T. Gulick

    2002-09-01

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

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

    Science.gov (United States)

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

    2015-04-01

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

  12. Radiation Induced Graft Copolymerization of Polyvinyl Alcohol

    International Nuclear Information System (INIS)

    In order to improve the properties of polyvinyl alcohol films and fibres, the graft copolymerization of various vinyl monomers to polyvinyl alcohol films by gamma ray irradiation was investigated. When thin films of polyvinyl alcohol were irradiated in a large excess of styrene no graft copolymerization was observed. With films containing more than 5% water the grafting proceeded smoothly. The highest value of styrene grafted was about 1,000% at a dose of 7X106r. The presence of water in the monomer solution was found to increase considerably the amount of grafted monomer. Methyl methacrylate behaved similarly to styrene in the grafting to polyvinyl alcohol films, the presence of a certain amount of water being essential. The efficiency of the grafting of methyl methacrylate was generally larger than that of the grafting of styrene. The highest value of the grafted methyl methacrylate was 4,000% and obtained at a dose of 5 X 105 r. Some experiments were carried out with acrylonitrile and vinyl acetate but compared with styrene and methyl methacrylate the efficiencies of the grafting of these monomers were not so high. The degree of swelling of the graft copolymers of polyvinyl-alcohol-styrene or methyl methacrylate in organic solvents was measured at 30oC. The relation between the degree of swelling and the percentage of monomer grafted was given by (degree of swelling %) = k (monomer grafted %)n. For polymers grafted with styrene n = 1, but for those grafted with methyl methacrylate n < 1. n and k have characteristic values which depend on the solvents used. (author)

  13. Homogeneous cation exchange membrane by radiation grafting

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1997-01-01

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

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

    Directory of Open Access Journals (Sweden)

    S. I. Suskov

    2011-06-01

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

  16. Strategies to prevent intraoperative lung injury during cardiopulmonary bypass

    Directory of Open Access Journals (Sweden)

    Siminelakis Stavros N

    2010-01-01

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

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

    Science.gov (United States)

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

    2015-09-01

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

  18. PNIPAM grafting on the surface of zirconium phosphate

    Science.gov (United States)

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

    2015-03-01

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

  19. Hydrophilic Silicone Resins Obtained by Radiation Grafting

    International Nuclear Information System (INIS)

    N-vinylpyrrolidone was grafted radiochemically on a silicone resin by pre-irradiation in the presence of oxygen. Under these conditions, peroxide groups capable of initiating radical copolymerization are formed. The trapped radicals do not seem to make any contribution. An RTV (Room Temperature Vulcanization) type silicone resin was used, i. e. a poly(dimethylsiloxane) crosslinked by vinyl-silane bonds. The unsaturated product was transparent. The silicones containing phenyl groups as well as saturated resins were also studied. Irradiation with 60Co gamma rays was performed in the 10-kCi irradiator of the Radiation Applications Group (GAR) at Saclay. Brief pre-irradiation tests with an electron accelerator were also performed. The amount of polyvinylpyrrolidone(PVP) grafted depends on the pre-irradiation dose and dose-rate as well as on the temperature and duration of the grafting proper. These different parameters were analysed. The grafting efficiency of PVP can be as much as 60%. The grafted copolymers are more or less opaque and coloured sections show that grafting remains peripheral. The transparency can be restored by immersion in water. The swelling in water is such that the ratio of absorbed water to grafted PVP varies between 0.8 and 1.5. When the grafting efficiency is higher than 50%, it is observed that the grafted PVP redissolves after swelling. The redissolving is due to the breaking of the grafted chains. For grafting rates below 30%, the grafted PVP silicones have notably high thermal stability. Examination of some properties of the grafted PVP silicones shows the additive nature of the properties of the grafted copolymers. Reference is made to the possible applications of these products, especially in biology and medicine. (author)

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

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2015-06-01

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

  3. 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)

  4. Micro- and Nanostructured Polymer Grafts

    OpenAIRE

    Steenackers, Marin

    2010-01-01

    The main aim of this work was the development of new strategies for the preparation of chemically stable micro- and nanostructured polymer grafts on various substrates. These new nanomaterials may open new perspectives in various fundamental and applied research areas such as sensor technologies, biomedicine, nanofluidics, nano-optics, biochip technologies and microelectronics. We have chosen for a two step strategy. First, the substrate is structured by electron beam lithography. In the seco...

  5. Acute graft versus host disease

    OpenAIRE

    Vogelsang Georgia B; Jacobsohn David A

    2011-01-01

    Abstract Acute graft-versus-host disease (GVHD) occurs after allogeneic hematopoietic stem cell transplant and is a reaction of donor immune cells against host tissues. Activated donor T cells damage host epithelial cells after an inflammatory cascade that begins with the preparative regimen. About 35%–50% of hematopoietic stem cell transplant (HSCT) recipients will develop acute GVHD. The exact risk is dependent on the stem cell source, age of the patient, conditioning, and GVHD prophylaxis ...

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

    Directory of Open Access Journals (Sweden)

    Ogata,Yoshitaka

    2008-08-01

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

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

    Directory of Open Access Journals (Sweden)

    Raissi Kamal

    2009-12-01

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

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

    International Nuclear Information System (INIS)

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

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

    DEFF Research Database (Denmark)

    Noordergraaf, G.J; Ottesen, Johnny T.

    2004-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Magura Stephen

    2012-11-01

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

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

    Directory of Open Access Journals (Sweden)

    Maria Meidani

    2008-10-01

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

  12. 2010 Survey on cell phone use while performing cardiopulmonary bypass.

    Science.gov (United States)

    Smith, T; Darling, E; Searles, B

    2011-09-01

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

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

    DEFF Research Database (Denmark)

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

    2012-01-01

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

  14. 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)

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

    LENUS (Irish Health Repository)

    Ong, J C Y

    2012-06-01

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

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

    Directory of Open Access Journals (Sweden)

    Ponzoni Deise

    2009-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Mirkhani S. H

    2002-07-01

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

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

    Directory of Open Access Journals (Sweden)

    Rasoul Ibrahim Abdulrahman

    2010-05-01

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

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

    Directory of Open Access Journals (Sweden)

    Diego Felipe Gaia

    2003-09-01

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

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

    Scientific Electronic Library Online (English)

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

    2003-09-01

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

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

    Science.gov (United States)

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

  2. Direct Transaortic Balloon Valvuloplasty Under Cardiopulmonary Bypass for Neonatal Critical Aortic Stenosis

    International Nuclear Information System (INIS)

    A 1-day-old male infant with critical aortic valvular stenosis underwent balloon aortic valvuloplasty (BAV) under echocardiographic guidance during cardiopulmonary bypass. Left ventricular function dramatically improved after BAV. This technique combined with a surgical approach was safe and efficient

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

    Science.gov (United States)

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

    2011-06-01

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

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

    OpenAIRE

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

    2007-01-01

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

  5. Electrokinetic properties of commercial vascular grafts

    OpenAIRE

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

    2012-01-01

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

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

    Science.gov (United States)

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

    1990-11-01

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

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

    Science.gov (United States)

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

    2015-10-01

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

  8. Membrane rigidity induced by grafted polymer brush.

    Science.gov (United States)

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

    2015-02-01

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

  9. The autologus graft of epithelial tissue culture

    Directory of Open Access Journals (Sweden)

    Minaee B

    1999-08-01

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

  10. 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)

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

    Directory of Open Access Journals (Sweden)

    Meybohm Patrick

    2011-03-01

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

  12. Industrial application of electron beams for grafting and vulcanization

    International Nuclear Information System (INIS)

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

  13. Synthesis of electroactive tetraaniline grafted polyethylenimine for tissue engineering

    Science.gov (United States)

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

    2015-07-01

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

  14. Onlay Bone Grafts in Head and Neck Reconstruction

    OpenAIRE

    Yazar, Sukru

    2010-01-01

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

  15. Employers' Guide to the Employment Equity Act

    OpenAIRE

    Lesley-Anne Katz

    2001-01-01

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

  16. Design and development of multilayer vascular graft

    Science.gov (United States)

    Madhavan, Krishna

    2011-07-01

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

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

    Science.gov (United States)

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

    2007-06-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-06-15

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

  19. Fertilizer Requirements for Grafted Tomato

    OpenAIRE

    M.F. Hossain; U. K. Majumder; M.A.S. Mondol; M.Z. Haque; M.M. Haque

    2003-01-01

    A pot experiment was conducted during November 2000 to March 2001 to find out the optimum fertilizer requirement of grafted tomato. Four levels of N, 4 levels of P, 4 levels of K, 2 levels of S and 1 kg sodium molybdate and 10 t ha?1 organic manure were applied in equal distribution to all these by using a selected set of 12 treatments. The highest tomato yield of 1459 g plant?1 was obtained with the application of 200 kg N, 120 kg P2O5, 80 kg K2O, 20 kg S ha?1, which was statistically simila...

  20. Lymphoid Tissue Grafts in Man

    International Nuclear Information System (INIS)

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

  1. Economics of grafted vs conventional watermelon plants

    Science.gov (United States)

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

  2. DSA and duplex ultrasonography in aorta grafts

    International Nuclear Information System (INIS)

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

  3. Graft healing in anterior cruciate ligament reconstruction

    Directory of Open Access Journals (Sweden)

    Chen Chih-Hwa

    2009-09-01

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

  4. Strategic sequences in fat graft survival.

    Science.gov (United States)

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

    2015-03-01

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

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

    OpenAIRE

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

    1993-01-01

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

  6. Robotically-Assisted Coronary Artery Bypass Grafting

    OpenAIRE

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

    2010-01-01

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

  7. Imaging features of anterior cruciate ligament reconstruction graft insufficiency

    International Nuclear Information System (INIS)

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

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

    Directory of Open Access Journals (Sweden)

    Suat Zengin

    2012-06-01

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

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

    OpenAIRE

    Pedro Miguel Garcez Sardo; Grace Teresinha Marcon Dal Sasso

    2007-01-01

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

  10. Conflicting Physiological and Genomic Cardiopulmonary Effects of Recruitment Maneuvers in Murine Acute Lung Injury

    OpenAIRE

    Mekontso Dessap, Armand; Voiriot, Guillaume; Zhou, Tong; Marcos, Elisabeth; Dudek, Steven M; Jacobson, Jeff R.; Machado, Roberto,; Adnot, Serge; Brochard, Laurent,; Maitre, Bernard; Garcia, Joe G. N.

    2012-01-01

    Low tidal volume ventilation, although promoting atelectasis, is a protective strategy against ventilator-induced lung injury. Deep inflation (DI) recruitment maneuvers restore lung volumes, but potentially compromise lung parenchymal and vascular function via repetitive overdistention. Our objective was to examine cardiopulmonary physiological and transcriptional consequences of recruitment maneuvers. C57/BL6 mice challenged with either PBS or LPS via aspiration were placed on mechanical ven...

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

    DEFF Research Database (Denmark)

    Al-Sabi, Mohammad Nafi Solaiman; Kapel, Christian Moliin Outzen; Johansson, Anna; Espersen, Mia C.; Koch, Jørgen; Willesen, Jakob L.

    2013-01-01

    A coprological survey was conducted to investigate the prevalence of parasites infect-ing hunting dogs with no history of recent anthelmintic treatments and with no overtclinical manifestations of cardiopulmonary or gastrointestinal illness. The hunting dogswere recruited from four different areas in Denmark, and fecal samples were obtainedin October and November, 2007. For detecting gastrointestinal parasites, samples (N = 178)were examined by a commercial flotation kit (Fecalyzer®EVSCO, USA). ...

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

    DEFF Research Database (Denmark)

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

    1994-01-01

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

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

    DEFF Research Database (Denmark)

    Kohno, Mitsutomo; Steinbrüchel, Daniel A

    2012-01-01

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

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

    Science.gov (United States)

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

    1999-01-01

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

  15. Marginally effective medical care: ethical analysis of issues in cardiopulmonary resuscitation (CPR)

    OpenAIRE

    Hilberman, M; Kutner, J; Parsons, D; Murphy, D. J.

    1997-01-01

    Outcomes from cardiopulmonary resuscitation (CPR) remain distressingly poor. Overuse of CPR is attributable to unrealistic expectations, unintended consequences of existing policies and failure to honour patient refusal of CPR. We analyzed the CPR outcomes literature using the bioethical principles of beneficence, non-maleficence, autonomy and justice and developed a proposal for selective use of CPR. Beneficence supports use of CPR when most effective. Non-maleficence argues against performi...

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

    OpenAIRE

    Lakshmi Rajeswaran; Valerie J. Ehlers

    2013-01-01

    Road traffic accident victims, as well as persons experiencing cardiac and other medical emergencies, might lose their lives due to the non-availability of trained personnel to provide effective cardio-pulmonary resuscitation (CPR) with functional equipment and adequate resources.The objectives of the study were to identify unit managers’ perceptions about challenges encountered when performing CPR interventions in the two referral public hospitals in Botswana. These results could be used to ...

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

    Science.gov (United States)

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

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

    OpenAIRE

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

    2001-01-01

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

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

    DEFF Research Database (Denmark)

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

    2007-01-01

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

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

    OpenAIRE

    Bagchi, S; Deshpande, S. B.

    2001-01-01

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

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

    DEFF Research Database (Denmark)

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

    2009-01-01

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

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

    OpenAIRE

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

    2004-01-01

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

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

    OpenAIRE

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

    2013-01-01

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

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

    OpenAIRE

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

    2011-01-01

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

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

    OpenAIRE

    Sabzi, Feridoun; Moloudi, Abdolrasoul

    2010-01-01

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

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

    OpenAIRE

    Samanta, Sukhen; Samanta, Sujay; Ghatak, Tanmoy

    2013-01-01

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

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

    OpenAIRE

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

    2009-01-01

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

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

    OpenAIRE

    G.F. Stegmann

    2012-01-01

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

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

    DEFF Research Database (Denmark)

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

    2013-01-01

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

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

    OpenAIRE

    Carlos Serrano; Mauricio Rocha e Silva

    2010-01-01

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

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

    OpenAIRE

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

    2009-01-01

    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...

  12. Cardiopulmonary exercise testing in congenital heart disease: (contra)indications and interpretation

    OpenAIRE

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

    2009-01-01

    Cardiopulmonary exercise testing (CPET) in paediatric cardiology differs in many aspects from the tests 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 rare in children. The main indications for CPET in children are evaluation of exercis...

  13. Adaptive significance of root grafting in trees

    Energy Technology Data Exchange (ETDEWEB)

    Loehle, C.; Jones, R.

    1988-12-31

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

  14. 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.)

  15. Amylose graft polymers made by 60Co gamma-irradiation

    International Nuclear Information System (INIS)

    Model products were needed to elucidate structure-property relationships in a starch graft polymer research program. Simultaneous irradiation of amylose and acrylamide in oxygen-free, dilute aqueous solutions gave graft polymers with maximum add-on of about 16 percent. The graft polymers were separated from homopolymer and subfractionated by incremental additions of nonsolvent (methyl or ethyl alcohol) to irradiated aqueous reaction media. The graft polymers were fairly homogeneous in graft content. Effects were determined of ratios of monomer to substrate, dose rate, and total dose on yield, graft content, intrinsic viscosity, and homopolymer characteristics. Under some conditions, crosslinks probably formed between graft side chains. Large differences in solution properties of a synthetic mixture of separately irradiated amylose and acrylamide and an irradiated solution of amylose and acrylamide indicated that grafting had occurred. Further evidence for true grafting was based on the action of a selective precipitant, n-butyl alcohol, on graft polymer solutions

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-02-15

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

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

    International Nuclear Information System (INIS)

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

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

    DEFF Research Database (Denmark)

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

    2015-01-01

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

  19. Graft copolymerization of acrylonitrile onto polypropylene membrane by preirradiation

    International Nuclear Information System (INIS)

    A porous, graft copolymer and amidoxime group containing membrane were prepared by radiation graft copolymerization of acrylonitrile onto porous polypropylene. In order to calculate the grafting and amidoxime ratios of porous polypropylene-acrylonitrile graft copolymer. We have done CHN elemental analysis. It is obtained the result that grafting rate is increased to linear and value was about 75 percent at 20 Mrad dose rate. (Author)

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

    Science.gov (United States)

    Lee, Rushyuan Jay; Ganley, Theodore J

    2014-10-01

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

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

    DEFF Research Database (Denmark)

    Hjortdal, Jesper; Pedersen, Iben B

    2013-01-01

    PURPOSE:: To compare the frequency of rejection episodes and graft failure because of surgical complications or rejection after Descemet stripping automated endothelial keratoplasty (DSAEK) and penetrating keratoplasty (PK) for Fuchs endothelial dystrophy. METHODS:: A total of 201 eyes of 201 consecutive patients with Fuchs endothelial dystrophy undergoing keratoplasty were included. One hundred two patients underwent DSAEK and 99 PK in the period January 1, 2000, to December 31, 2010. Postoperative topical steroid treatment was similar in the 2 groups. Most patients in the PK group received a short course of oral prednisolone, which was not prescribed for patients undergoing DSAEK. Patient records were retrospectively reviewed; rejection episodes and causes of graft failures were recorded, and Kaplan-Meier survival curves up to 5 years after surgery were computed and compared. RESULTS:: All rejection episodes and most graft failures occurred during the first 2 years after surgery. In this period, rejection episodes were noted in 16% of PK and in 5% of DSAEK-treated eyes (P = 0.03). During the first 5 years, significantly more DSAEK grafts than PK grafts had failed (P = 0.04) but only 2 PK-treated and no DSAEK-treated grafts failed because of rejection. CONCLUSION:: The frequency of graft rejection episodes is higher after PK than DSAEK for primary endothelial disease, despite the use of oral prednisolone in the PK group. Early graft failure is more common after DSAEK than after PK, whereas graft failure because of previous rejection episodes is uncommon after DSAEK and PK.

  2. Kinetic and mechanism of radiation-induced graft copolymerization for two grafting systems

    International Nuclear Information System (INIS)

    The graft copolymerization of glycidyl methacrylate (GMA) and vinylbenzyl chloride (VBC) onto nylon fiber was investigated by the pre-irradiation method using electron beam. The effects of grafting parameters, such as monomer concentration, absorbed dose and reaction temperature were investigated. The empirical kinetic rate equations: dG0/ dt = k(Mg0)1.14(Ag)0.52 and dG0/dt = k(Mv0)0.86(Av)1.06, were used to describe grafting of GMA and VBC, respectively. The overall activation energy for graft copolymerization of GMA and VBC were found to be 5.4 and 22.6 kJ/mol, respectively. The results revealed that the grafting kinetics in the two grafting systems were both controlled by the amounts of trapped radicals and monomer molecules. The grafting of GMA onto nylon-6 fibers was found to exhibit higher dependency on the quantity of monomer molecules available, whereas the VBC grafting system was found to exhibit higher dependency on the quantity of trapped radicals. Fourier transform infrared spectroscopy (FT-IR) and scanning electron microscopy (SEM) were used to provide evidence for the formation of graft copolymers. (author)

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

    Scientific Electronic Library Online (English)

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

    2002-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Flávio Donizete Gonçalves

    2002-12-01

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

  5. 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

  6. 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

  7. Employment Polarization and Immigrant Employment Opportunities

    OpenAIRE

    Wielandt, Hanna

    2015-01-01

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

  8. Retrenchment in Malaysia: Employer’s Right?

    OpenAIRE

    Hamidah Marsono; Hj. Kamaruzaman Jusoff

    2008-01-01

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

  9. Mechanical Bench Grafting for Apple Propagation

    OpenAIRE

    Muhammad Ashraf Sumrah; Allah Bakhsh; Zahid Hussain; Shafique Ahmad

    2002-01-01

    Mechanically and manually prepared stock and scion for bench grafting were adopted in four phases for apple propagation i.e., mechanically made stock and manually prepared scion, second phase was vice versa while in third stage both the stock and scion were prepared mechanically. In fourth operation all the grafting process was performed by hand made scion and stock. Maximum sprouting and success percentage of 93.2 and 83.2 respectively was recorded in the mechanically prepared scion and stoc...

  10. Delayed Graft Function in the Kidney Transplant

    OpenAIRE

    Siedlecki, Andrew; IRISH, WILLIAM; Brennan, Daniel C.

    2011-01-01

    Acute kidney injury occurs with kidney transplantation and too frequently progresses to the clinical diagnosis of delayed graft function (DGF). Poor kidney function in the first week of graft life is detrimental to the longevity of the allograft. Challenges to understand the root cause of DGF include several pathologic contributors derived from the donor (ischemic injury, inflammatory signaling) and recipient (reperfusion injury, the innate immune response, and the adaptive immune response). ...

  11. Seeking for the ideal stent graft

    OpenAIRE

    Isa Cristina Teixeira Santos; Luís Rocha; João Manuel Ribeiro da Silva Tavares

    2010-01-01

    Aortic aneurysms are localized dilatations of the aorta that if not treated may lead to death. One of the current treatments is endovascular repair, a minimal invasive procedure in which a stent graft is placed transluminally to prevent wall rupture shielding the aneurysm from blood pressure. Stent grafts are classified as class III medical devices. They are composed of a metallic scaffold covered by a polymeric membrane. While early devices were custom designed by the operating surgeon, n...

  12. Polypeptide Grafted Hyaluronan: Synthesis and Characterization

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-01-01

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

  13. Evaluation of Factors Influencing Liver Function Test in On-Pump Coronary Artery Bypass Graft Surgery

    Directory of Open Access Journals (Sweden)

    Shahrbano Shahbazi

    2013-12-01

    Full Text Available Background: Liver dysfunction during on-pump coronary artery bypass graft surgery (CABG is a rare complication but is associated with significant morbidity and mortality. The ability to identify high-risk patients may be helpful in planning appropriate management strategies. We aimed to evaluate the factors influencing liver function tests during on-pump CABG. Methods: In 146 patients scheduled for on-pump CABG, the liver function test was done preoperatively and on the first postoperative day. Some preoperative and intraoperative risk factors were checked and then the postoperative liver function tests were compared with the preoperative ones. Probable relationships between these changes and the preoperative and intraoperative risk factors were studied. Results: A medical history of diabetes had a significant relationship with the changes in direct bilirubin. Preoperative central venous pressure had a significant relationship with the changes in aspartate aminotransferase and alanine aminotransferase. Use of intra-aortic balloon pump and duration of aortic cross-clamp were significantly related to the changes in the liver function tests except for alanine aminotransferase and alkaline phosphatase. Conclusion: It seems that the techniques for the reduction of cardiopulmonary bypass and aortic cross-clamp duration may be useful to protect liver function. We recommend that a larger population of patients be studied to confirm these findings.

  14. Bloodless off pump coronary artery bypass grafting treatment of choice for Jehova's witness patients.

    Science.gov (United States)

    Mujanovic, Emir; Bergsland, Jacob; Jahic, Mirza; Djedovic, Samed; Behrem, Adnan; Stanimirovic-Mujanovic, Sanja; Kabil, Emir

    2012-01-01

    Jehovah's witnesses (JW) belong to a religious group refusing to accept blood transfusion Surgical treatment remains a challenge in this subset of patients. From 1945, JW introduced a ban on accepting blood transfusions, even in life-threatening situations while autologous blood must also be refused if it is predeposited-thus excluding preoperative autodonation. However, autologous blood is acceptable if it is not separated from the patients' circulation at any time. The invasive nature of coronary artery bypass grafting (CABG), the associated decrease of body temperature and the use of cardiopulmonary bypass (CPB) are major reasons for increased blood loss and high incidence for blood transfusions during and after this procedures. Allogenic blood transfusions are often given and considered necessary in such operations, in spite of increased mortality, morbidity and major adverse outcomes resulting from transfusion. Reduction in the use of blood products should therefore be a general desire for every patient due to the associated risk factors. The evolution of less invasive cardiac surgical approaches, such as CABG without CPB (OPCAB) may contribute to a further reduction of blood transfusion and although these minimally invasive techniques may benefit every patient, they might be particularly valuable for JW. In this report, we present our initial experience in JW patient undergoing OPCAB and the way to use patient blood management for improved surgical outcome in such patient. PMID:22486150

  15. Physical properties of agave cellulose graft polymethyl methacrylate

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-11-27

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

  16. 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

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

    Science.gov (United States)

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

    2015-05-15

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

  18. Self-deploying shape memory polymer scaffolds for grafting and stabilizing complex bone defects: A mouse femoral segmental defect study.

    Science.gov (United States)

    Baker, Richard M; Tseng, Ling-Fang; Iannolo, Maria T; Oest, Megan E; Henderson, James H

    2016-01-01

    Treatment of complex bone defects places a significant burden on the US health care system. Current strategies for treatment include grafting and stabilization using internal metal plates/screws, intramedullary rods, or external fixators. Here, we introduce the use of shape memory polymer (SMP) materials for grafting and adjunct stabilization of segmental defects. Self-deploying SMP grafts and SMP sleeves capable of expanding and contracting, respectively, under intraoperative conditions were developed and evaluated in a mouse segmental defect model in vivo. Integration between grafts/sleeves and native bone was assessed using x-ray radiography, microcomputed tomography, and torsional mechanical testing. We found that SMP grafts were able to integrate with the native bone after 12 weeks, maintain defect stability, and provide torsional mechanical properties comparable to an allograft alone treatment; however no gross de novo bone formation was observed. SMP sleeves did not inhibit bony bridging at the margins, and limbs treated with a sleeve/allograft combination had torsional mechanical properties comparable to limbs treated with an allograft alone. In vitro torsional and bending tests suggest sleeves may provide additional torsional stability to defects. Incorporation of shape memory into synthetic bone graft substitutes and adjunct stabilization devices is anticipated to enhance functionality of synthetic materials employed in both applications. PMID:26561935

  19. Isotopic scintigraphy in kidney grafting

    International Nuclear Information System (INIS)

    Isotopic explorations of kidney transplants were performed on sixty-six patients. Three scintigraphic techniques were used: labelled ferrous ascorbate scintigraphy, sequential 99m technetium DTPA scintigraphy and the 131I hippuran nephrogram. The aim of this study is to analyse the results obtained under different pathological circumstances affecting the transplant, to discuss the advantages of the techniques and to propose a working procedure. The most reliable and accurate technique is the 131I hippuran nephrogram combined with sequential 99mTc DTPA, by which renal vascularisation may be judged labelled ferrous ascorbate on the other hand is too insensitive. Although the information supplied is mostly contained in the scintigraphic images, the nephrographic curves and the blood radioactivity decay time and rad V/rad R ratio measurements are very helpful in the early diagnosis and differential diagnosis of complications affecting the transplant. The proper use of isotopic scintigraphy in kidney grafting should provide optimum conditions for better survival of the transplant at minimum risk to the patient

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

    Directory of Open Access Journals (Sweden)

    José Glauco Lobo Filho

    2010-03-01

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

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

    Scientific Electronic Library Online (English)

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

    2010-03-01

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

  2. Anesthetic management of a patient with polycythemia vera undergoing emergency repair of a type-A aortic dissection and concomitant coronary artery bypass grafting: a case report

    Science.gov (United States)

    Im, Hyeongwoo; Yang, Jaeyoung; Lee, Sangmin Maria; Lee, Jong Hwan

    2015-01-01

    Polycythemia vera is a chronic progressive myeloproliferative disease characterized by increased circulating red blood cells, and the hyperviscosity of the blood can lead to an increased risk of arterial thrombosis. In a previous survey regarding postoperative outcomes in polycythemia vera patients, an increased risk of both vascular occlusive and hemorrhagic complications have been reported. Aortic surgery involving cardiopulmonary bypass may be associated with the development of a coagulopathy, and as a result, the occurrence of thrombotic complications should be avoided after coronary anastomosis. Thus, optimizing the hemostatic balance is an important concern for anesthesiologists. However, only a few cases of anesthetic management in polycythemia vera patients undergoing concomitant aorta and coronary arterial bypass surgery have ever been reported. Here, we experience a polycythemia vera patient who underwent an emergency repair of a type-A aortic dissection and concomitant coronary artery bypass grafting, and report this case with a review of the relevant literature. PMID:26634086

  3. Effect of acid additives on grafting efficiency and water absorption of hydrolyzed cassava starch grafted polymers

    International Nuclear Information System (INIS)

    Gelatinized cassava starch was radiation graft copolymerized with acrylamide, acrylic acid or their mixture in the presence of sulphuric acid or maleic acid. Various acid concentrations were used from 0.001 to 0.1 M of sulphuric acid while the maleic acid concentrations were varied from 1 to 3% (by weight). The optimum total dose and dose rate were investigated. The saponification temperature and time had the marked effects on grafting characteristics and water absorption capacity. We found that the effect of maleic acid addition gave a profound effect on water absorption. The CHNS/O analyses indicated significant changes in the nitrogen content in the hydrolyzed starch grafted polyacrylamide with 2% maleic acid. The article explains the possible causes for the enhancement influence of mineral acid and maleic acid on grafting behavior and water absorption of the saponified cassava starch grafted polyacrylamide super absorbent polymer. (author)

  4. Surface Grafting via Photo-Induced Copper-Mediated Radical Polymerization at Extremely Low Catalyst Concentrations.

    Science.gov (United States)

    Laun, Joachim; Vorobii, Mariia; de Los Santos Pereira, Andres; Pop-Georgievski, Ognen; Trouillet, Vanessa; Welle, Alexander; Barner-Kowollik, Christopher; Rodriguez-Emmenegger, Cesar; Junkers, Thomas

    2015-09-01

    Surface-initiated photo-induced copper-mediated radical polymerization is employed to graft a wide range of polyacrylate brushes from silicon substrates at extremely low catalyst concentrations. This is the first time that the controlled nature of the reported process is demonstrated via block copolymer formation and re-initiation experiments. In addition to unmatched copper catalyst concentrations in the range of few ppb, film thicknesses up to almost 1 ?m are achieved within only 1 h. PMID:26149622

  5. Free Gingival Grafting; Epiglu VS. Silk Thread Suturing: A Comparative Study

    OpenAIRE

    M. Paknejad; Y. Soleymani Shayesteh; A. Esmaielieh

    2004-01-01

    Statement of the Problem: The routine procedure for immobilization of free gingival graft (FGG) is suturing. Due to the successful application of tissue adhesives their employment has also become the subject of interest.Purpose: The aim of present clinical trial was to compare using Epiglu (E.g) versus silk thread suturing in FGG.Materials and Methods: This study was a split mouth clinical trial. The study group comprised of 12 patients with symmetrical loss of attached gingiva whom were refe...

  6. Adolescent External Iliac Artery Trauma: Recurrent Aneurysmal Dilatation of an Iliofemoral Saphenous Vein Graft Treated by Stent-Grafting

    International Nuclear Information System (INIS)

    An adolescent male sustained a severe penetrating injury to the external iliac artery. Emergency surgical revascularization was with a reversed long saphenous vein interposition graft. The primary graft and the subsequent revision graft both became aneurysmal. The second graft aneurysm was successfully excluded by endovascular stent-grafts with medium-term primary patency. A venous graft was used initially rather than a synthetic graft to reduce the risk of infection and the potential problems from future growth. Aneurysmal dilatation of venous grafts in children and adolescents is a rare but recognized complication. To the best of our knowledge, exclusion of these aneurysms with stent-grafts has not been previously reported in the adolescent population.

  7. Synthesis of Graft Copolymers by Small Doses of Irradiation

    International Nuclear Information System (INIS)

    In addition to grafting, there is often an undesirable alteration in the properties of the original polymer when polymer monomer mixtures are irradiated. As a result of irradiation, grafting occurs not only on the original polymeric backbone, but also on the already grafted side-chains. The result is an acceleration of grafting. The effect is especially pronounced in the case of preformed polymers, if irradiation is carried out intermittently. The grafting of styrene can be accelerated by the addition of some solvents which suppress the protective effect of the styrene on the polymer. Grafting can be accelerated by other additives. The swelling properties of the irradiated films were investigated. (author)

  8. Grafting of acrylamide onto synthetic co polyamide by gamma irradiation

    International Nuclear Information System (INIS)

    Grafted copolymer was prepared by using gamma irradiation to graft acrylamide onto polymeric molecule prepared by interfacial condensation between two diamine molecules like 1,2 diamino propane and 1,6 diamino-hexane in aqueous layer with sebacoyl chloride in organic layer. The resulted co polyamide was grafted with acrylamide using gamma irradiation. The optimum conditions of grafting reaction were found, also various factors such as the effect of solvents, redox systems and the role water on the radiochemical grafting were studied. Many techniques were used in the characterization of the copolymer before and after grafting. 8 figs.,

  9. Characterization and Some Properties of Functionalized Graft Copolymer

    International Nuclear Information System (INIS)

    The study involved the investigation and characterization of membranes prepared by graft copolymerization of acrylonitrile (AN) and vinyl acetate (VAc) binary monomers onto low density polyethylene (LDPE) and isotactic polypropylene (IPP). The mutual gamma-irradiation method was used as a grafting technique. The effects of grafting and chemical treatments on the thermal properties and crystallinity of prepared graft copolymer have been investigated using DSC, TGA and XRD. IR spectra recorded before and after grafting and also for the chemically treated membranes to elucidate the structural changes occurred due to grafting and chemical treatments

  10. Atherosclerosis of coronary artery bypass grafts and smoking.

    OpenAIRE

    FitzGibbon, G M; Leach, A J; Kafka, H P

    1987-01-01

    Follow-up angiography was performed at selected intervals on 340 men who had undergone coronary artery bypass surgery. There were 1160 grafts, but 112 were excluded from study because they occluded shortly after the operation. After 5 years 115 patients were smokers and 225 were nonsmokers. The mean number of grafts per patient was similar in the two groups. We classified each graft according to irregularities in graft outlines and graft patency and found disease-free grafts in 39% of the smo...

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

    Directory of Open Access Journals (Sweden)

    Ashraf Omer

    2005-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Maria Celia Barcellos Dalri

    2008-12-01

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

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

    International Nuclear Information System (INIS)

    Purpose: The use of preclinical rodent models of disease continues to grow because these models help elucidate pathogenic mechanisms and provide robust test beds for drug development. Among the major anatomic and physiologic indicators of disease progression and genetic or drug modification of responses are measurements of blood vessel caliber and flow. Moreover, cardiopulmonary blood flow is a critical indicator of gas exchange. Current methods of measuring cardiopulmonary blood flow suffer from some or all of the following limitations--they produce relative values, are limited to global measurements, do not provide vasculature visualization, are not able to measure acute changes, are invasive, or require euthanasia. Methods: In this study, high-spatial and high-temporal resolution x-ray digital subtraction angiography (DSA) was used to obtain vasculature visualization, quantitative blood flow in absolute metrics (ml/min instead of arbitrary units or velocity), and relative blood volume dynamics from discrete regions of interest on a pixel-by-pixel basis (100x100 ?m2). Results: A series of calibrations linked the DSA flow measurements to standard physiological measurement using thermodilution and Fick's method for cardiac output (CO), which in eight anesthetized Fischer-344 rats was found to be 37.0±5.1 ml/min. Phantom experiments were conducted to calibrate the radiographic density to vessel thickness, allowing a link of DSA cardiac output measurements to cardiopulmonary blood flow measurements in discrete regions of interest. The scaling factor linking relative DSA cardiac output measurements to the Fick's absolute measurements was found to be 18.90xCODSA=COFick. Conclusions: This calibrated DSA approach allows repeated simultaneous visualization of vasculature and measurement of blood flow dynamics on a regional level in the living rat.

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

    Energy Technology Data Exchange (ETDEWEB)

    Lin Mingde; Marshall, Craig T.; Qi, Yi; Johnston, Samuel M.; Badea, Cristian T.; Piantadosi, Claude A.; Johnson, G. Allan [Department of Radiology, Center for In Vivo Microscopy and Department of Biomedical Engineering, Duke University Medical Center, Box 3302, Durham, North Carolina 27710 (United States); Division of Pulmonary and Critical Care Medicine and Center for Hyperbaric Medicine and Environmental Physiology, Duke University Medical Center, Box 3823, Durham, North Carolina 27710 (United States); Department of Radiology, Center for In Vivo Microscopy, Duke University Medical Center, Box 3302, Durham, North Carolina 27710 (United States); Department of Radiology, Center for In Vivo Microscopy and Department of Biomedical Engineering, Duke University Medical Center, Box 3302, Durham, North Carolina 27710 (United States); Department of Radiology, Center for In Vivo Microscopy, Duke University Medical Center, Box 3302, Durham, North Carolina 27710 (United States); Division of Pulmonary and Critical Care Medicine and Center for Hyperbaric Medicine and Environmental Physiology, Duke University Medical Center, Box 3823, Durham, North Carolina 27710 (United States); Department of Radiology, Center for In Vivo Microscopy and Department of Biomedical Engineering, Duke University Medical Center, Box 3302, Durham, North Carolina 27710 (United States)

    2009-11-15

    Purpose: The use of preclinical rodent models of disease continues to grow because these models help elucidate pathogenic mechanisms and provide robust test beds for drug development. Among the major anatomic and physiologic indicators of disease progression and genetic or drug modification of responses are measurements of blood vessel caliber and flow. Moreover, cardiopulmonary blood flow is a critical indicator of gas exchange. Current methods of measuring cardiopulmonary blood flow suffer from some or all of the following limitations--they produce relative values, are limited to global measurements, do not provide vasculature visualization, are not able to measure acute changes, are invasive, or require euthanasia. Methods: In this study, high-spatial and high-temporal resolution x-ray digital subtraction angiography (DSA) was used to obtain vasculature visualization, quantitative blood flow in absolute metrics (ml/min instead of arbitrary units or velocity), and relative blood volume dynamics from discrete regions of interest on a pixel-by-pixel basis (100x100 {mu}m{sup 2}). Results: A series of calibrations linked the DSA flow measurements to standard physiological measurement using thermodilution and Fick's method for cardiac output (CO), which in eight anesthetized Fischer-344 rats was found to be 37.0{+-}5.1 ml/min. Phantom experiments were conducted to calibrate the radiographic density to vessel thickness, allowing a link of DSA cardiac output measurements to cardiopulmonary blood flow measurements in discrete regions of interest. The scaling factor linking relative DSA cardiac output measurements to the Fick's absolute measurements was found to be 18.90xCO{sub DSA}=CO{sub Fick}. Conclusions: This calibrated DSA approach allows repeated simultaneous visualization of vasculature and measurement of blood flow dynamics on a regional level in the living rat.

  15. Cardiopulmonary Bypass and Extracorporeal Life Support for Emergent Intraoperative Thoracic Situations.

    Science.gov (United States)

    Machuca, Tiago N; Cypel, Marcelo; Keshavjee, Shaf

    2015-08-01

    Intraoperative thoracic surgical catastrophes may require extracorporeal circulation modes to support the patient while the appropriate repair is made. Teamwork is key and, given the evidence supporting better performance with the use of simulation and surgical-crisis checklists, their use should be encouraged. Anticipation is another important factor because the results of intrathoracic malignancy resection are clearly superior in the setting of planned cardiopulmonary support. In addition, familiarity with the different modes of support that are currently available can direct the decision-making process toward the best option to facilitate resolution of the intraoperative catastrophe with the least related morbidity. PMID:26210928

  16. Should blood flow during cardiopulmonary bypass be individualized more than to body surface area?

    DEFF Research Database (Denmark)

    Thomassen, Sisse Anette; Larsson, A; Andreasen, Jan Jesper; Bundgaard, W; Rasmussen, Bodil Steen

    2012-01-01

    Blood flow during cardiopulmonary bypass (CPB) is calculated on body surface area (BSA). Increasing comorbidity, age and weight of today's cardiac patients question this calculation as it may not reflect individual metabolic requirement. The hypothesis was that a measured cardiac index (CI) prior to normothermic CPB is a better estimate. A cross-over study, with random allocation to CPB blood flow for 20 minutes based on either a calculation (2.4 L/min/m(2)) or on CI, with a switch to the opposi...

  17. Should blood flow during cardiopulmonary bypass be individualized more than to body surface area?

    DEFF Research Database (Denmark)

    Thomassen, Sisse Anette; Larsson, A; Andreasen, Jan Jesper; Bundgaard, W; Bøgsted, M; Rasmussen, Bodil Steen

    2011-01-01

    Blood flow during cardiopulmonary bypass (CPB) is calculated on body surface area (BSA). Increasing comorbidity, age and weight of today's cardiac patients question this calculation as it may not reflect individual metabolic requirement. The hypothesis was that a measured cardiac index (CI) prior to normothermic CPB is a better estimate. A cross-over study, with random allocation to CPB blood flow for 20 minutes based on either a calculation (2.4 L/min/m(2)) or on CI, with a switch to the opposi...

  18. Modelling ventricular fibrillation coarseness during cardiopulmonary resuscitation by mixed effects stochastic differential equations.

    Science.gov (United States)

    Gundersen, Kenneth; Kvaløy, Jan Terje; Eftestøl, Trygve; Kramer-Johansen, Jo

    2015-10-15

    For patients undergoing cardiopulmonary resuscitation (CPR) and being in a shockable rhythm, the coarseness of the electrocardiogram (ECG) signal is an indicator of the state of the patient. In the current work, we show how mixed effects stochastic differential equations (SDE) models, commonly used in pharmacokinetic and pharmacodynamic modelling, can be used to model the relationship between CPR quality measurements and ECG coarseness. This is a novel application of mixed effects SDE models to a setting quite different from previous applications of such models and where using such models nicely solves many of the challenges involved in analysing the available data. PMID:26013575

  19. Expression of adhesion and activation molecules on lymphocytes during open-heart surgery with cardiopulmonary bypass

    DEFF Research Database (Denmark)

    Toft, P; Tønnesen, Else Kirstine; Zülow, I; Nielsen, C H; Hokland, Marianne

    1997-01-01

    Open-heart surgery with cardiopulmonary bypass (CPB) and abdominal surgery are associated with lymphocytopenia. We measured a panel of adhesion and activation molecules on lymphocytes to clarify possible association of CPB with increased expression of these molecules. Eight patients undergoing open-heart surgery and eight with abdominal surgery were studied. The adhesion molecules CD11a/CD18 (LFA-1_, CD11c/CD18 and CD44 and the activation molecules CD25, CD69, CD71 and MHCII were measured, using...

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

    LENUS (Irish Health Repository)

    Hargrove, M

    2012-02-03

    The incidence of electrical failure during cardiopulmonary bypass (CPB) has been reported to occur in approximately 1 per 1000 cases. While the resultant morbidity and mortality is low, electrical failure is a life-threatening scenario. We report three major electrical failures during CPB in a patient population of 3500 over a 15-year period. These cases involved mains failure and generator shut down, mains failure and generator power surge, and failure of the uninterruptable power supply (UPS), which caused protected sockets to shut down. Protocols for preventative maintenance, necessary equipment, battery backup and guidelines for the successful management of such accidents during CPB are discussed.

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

    Directory of Open Access Journals (Sweden)

    Qian Yanning

    2011-08-01

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

  2. Stability of relative oxygen pulse curve during repeated maximal cardiopulmonary testing in professional soccer players

    OpenAIRE

    R.R. Perim; G.R. Signorelli; Araújo, C.G.S.

    2011-01-01

    During cardiopulmonary exercise testing (CPET), stroke volume can be indirectly assessed by O2 pulse profile. However, for a valid interpretation, the stability of this variable over time should be known. The objective was to analyze the stability of the O2 pulse curve relative to body mass in elite athletes. VO2, heart rate (HR), and relative O2 pulse were compared at every 10% of the running time in two maximal CPETs, from 2005 to 2010, of 49 soccer players. Maximal values of VO2 (63.4 ± 0....

  3. Corneal Graft Rejection: Incidence and Risk Factors

    Directory of Open Access Journals (Sweden)

    Alireza Baradaran-Rafii

    2008-12-01

    Full Text Available

    PURPOSE: To determine the incidence and risk factors of late corneal graft rejection after penetrating keratoplasty (PKP. METHODS: Records of all patients who had undergone PKP from 2002 to 2004 without immunosuppressive therapy other than systemic steroids and with at least one year of follow up were reviewed. The role of possible risk factors such as demographic factors, other host factors, donor factors, indications for PKP as well as type of rejection were evaluated. RESULTS: During the study period, 295 PKPs were performed on 286 patients (176 male, 110 female. Mean age at the time of keratoplasty was 38±20 (range, 40 days to 90 years and mean follow up period was 20±10 (range 12-43 months. Graft rejection occurred in 94 eyes (31.8% at an average of 7.3±6 months (range, 20 days to 39 months after PKP. The most common type of rejection was endothelial (20.7%. Corneal vascularization, regrafting, anterior synechiae, irritating sutures, active inflammation, additional anterior segment procedures, history of trauma, uncontrolled glaucoma, prior graft rejection, recurrence of herpetic infection and eccentric grafting increased the rate of rejection. Patient age, donor size and bilateral transplantation had no significant influence on graft rejection. CONCLUSION: Significant risk factors for corneal graft rejection include corneal vascularization, anterior synechiae, irritating sutures, active inflammation, regrafting, additional surgery, trauma, uncontrolled intraocular pressure, history of graft rejection, recurrent herpetic infection, eccentric grafting and corneal scarring. Recipient age and donor cornea size do not seem to be risk factors for corneal graft rejection.

  4. "Employability-miles" and worker employability awareness

    OpenAIRE

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

    2012-01-01

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

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

    DEFF Research Database (Denmark)

    Javakhishvili, Irakli; Jankova Atanasova, Katja

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

  6. Acute graft versus host disease

    Directory of Open Access Journals (Sweden)

    Vogelsang Georgia B

    2007-09-01

    Full Text Available Abstract Acute graft-versus-host disease (GVHD occurs after allogeneic hematopoietic stem cell transplant and is a reaction of donor immune cells against host tissues. Activated donor T cells damage host epithelial cells after an inflammatory cascade that begins with the preparative regimen. About 35%–50% of hematopoietic stem cell transplant (HSCT recipients will develop acute GVHD. The exact risk is dependent on the stem cell source, age of the patient, conditioning, and GVHD prophylaxis used. Given the number of transplants performed, we can expect about 5500 patients/year to develop acute GVHD. Patients can have involvement of three organs: skin (rash/dermatitis, liver (hepatitis/jaundice, and gastrointestinal tract (abdominal pain/diarrhea. One or more organs may be involved. GVHD is a clinical diagnosis that may be supported with appropriate biopsies. The reason to pursue a tissue biopsy is to help differentiate from other diagnoses which may mimic GVHD, such as viral infection (hepatitis, colitis or drug reaction (causing skin rash. Acute GVHD is staged and graded (grade 0-IV by the number and extent of organ involvement. Patients with grade III/IV acute GVHD tend to have a poor outcome. Generally the patient is treated by optimizing their immunosuppression and adding methylprednisolone. About 50% of patients will have a solid response to methylprednisolone. If patients progress after 3 days or are not improved after 7 days, they will get salvage (second-line immunosuppressive therapy for which there is currently no standard-of-care. Well-organized clinical trials are imperative to better define second-line therapies for this disease. Additional management issues are attention to wound infections in skin GVHD and fluid/nutrition management in gastrointestinal GVHD. About 50% of patients with acute GVHD will eventually have manifestations of chronic GVHD.

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

    International Nuclear Information System (INIS)

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

  8. Radiographic analysis of pasteurized autologous bone graft

    International Nuclear Information System (INIS)

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

  9. Nerve grafting in peripheral nerve injuries

    Directory of Open Access Journals (Sweden)

    Simi? Vesna D.

    2003-01-01

    Full Text Available Autologous nerve grafting is the most commnly used operative technique in delayed primary, or secondary nerve repair after the peripheral nerve injuries. The aim of this procedure is to overcome nerve gaps that results from the injury itself, fibrous and elastic retraction forces, resection of the damaged parts of the nerve, position of the articulations and mobilisation of the nerve.In this study we analyse the results of operated patients with transections and lacerations of the peripheral nerves from 1979 to 2000 year. Gunshot injuries have not been analyzed in this study. The majority of the injuries were in the upper extremity (more than 87% of cases. Donor for nerve transplantation had usually been sural nerve, and only occasionally medial cutaneous nerve of the forearm was used. In about 93% of cases we used interfascicular nerve grafting, and cable nerve grafting was performed in the rest of them. Most of the grafts were 1 do 5 cm long (70% of cases. Functional recovery was achieved in more than 86% of cases, which is similar to the results of the other authors. Follow up period was minimum 2 years. We analyzed the influence of different factors on nerve recovery after the operation: patient’s age, location and the extent (total or partial of nerve injury, the length of the nerve graft, type of the nerve, timing of surgery, presence of multiple nerve injuries and associated osseal and soft tissue injuries of the upper and lower extremities.

  10. Mechanism of radiation ion graft polymerization

    Energy Technology Data Exchange (ETDEWEB)

    Kabanov, V.Ya.; Aliyev, R.E.; Kudryavtsev, V.N.; Sidorova, L.P.; Spitsyn, V.I.

    1982-04-01

    The mechanism of triggering ion graft polymerization, taking into account the frequency heterogeneity of the grafting process, is examined. It is pointed out that the ion process in radiolysis has received much less attention than the behavior of radicals, and these factors are discussed for polyolefins. Data on the effects of solvents showed a correlation between solvent donor numbers and the rate of grafting, and a complete lack of correlation with other properties of solvents. For radiation ion grafting, polymer swelling in the solvent has less importance than the solvent's donor-acceptor properties. Ion grafting reaches its greatest speed at the glass point of the swelled polymer. Results showed that the solvent's effect on copolymer composition is strikingly different as the amount of solvent is increased. A formula is developed for the dependence of the ion process's contribution on the strength of the solvent dose and the content of inhibiting impurities (such as water) in the system. 9 references, 4 figures.

  11. Radiation graft modification of EPDM rubber

    International Nuclear Information System (INIS)

    N-Vinyl pyrrolidone (NVP), 2-hydroxyethylmethacrylate (HEMA) and acrylamide (AAm) have been grafted to the surface of rubber vulcanizates based on ethylene-propylene-terpolymer (EPDM) using the simultaneous radiation method to alter surface properties such as wettability and therefore biocompatibility. The effect of monomer concentration, solvent and EPDM structural factors on the grafting behaviour have been investigated. The inhibitory effect upon homopolymerization of various salts has also been evaluated for the three monomers. A mechanism has been proposed to explain the behaviour of these monomers. The inclusion of multifunctional acrylates in additive amounts (1.0 vol%) enhanced the graft degree. Modified samples were able to be efficiently stained, allowing the depth of the graft copolymerization to be determined by light microscopy. Water was found to have an accelerating effect on the polymerization of these monomers, but methanol prevented their polymerization completely. The effect of EPDM structural factors upon degree of grafting was found to vary, depending upon the monomer type. (author)

  12. Soft tissue grafting to improve implant esthetics

    Science.gov (United States)

    Kassab, Moawia M

    2010-01-01

    Dental implants are becoming the treatment of choice to replace missing teeth, especially if the adjacent teeth are free of restorations. When minimal bone width is present, implant placement becomes a challenge and often resulting in recession and dehiscence around the implant that leads to subsequent gingival recession. To correct such defect, the author turned to soft tissue autografting and allografting to correct a buccal dehiscence around tooth #24 after a malpositioned implant placed by a different surgeon. A 25-year-old woman presented with the chief complaint of gingival recession and exposure of implant threads around tooth #24. The patient received three soft tissue grafting procedures to augment the gingival tissue. The first surgery included a connective tissue graft to increase the width of the keratinized gingival tissue. The second surgery included the use of autografting (connective tissue graft) to coronally position the soft tissue and achieve implant coverage. The third and final surgery included the use of allografting material Alloderm to increase and mask the implant from showing through the gingiva. Healing period was uneventful for the patient. After three surgical procedures, it appears that soft tissue grafting has increased the width and height of the gingiva surrounding the implant. The accomplished thickness of gingival tissue appeared to mask the showing of implant threads through the gingival tissue and allowed for achieving the desired esthetic that the patient desired. The aim of the study is to present a clinical case with soft tissue grafting procedures. PMID:23662087

  13. 21 CFR 870.3450 - Vascular graft prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Vascular graft prosthesis. 870.3450 Section 870... prosthesis. (a) Identification. A vascular graft prosthesis is an implanted device intended to repair... Prostheses 510(k) Submissions.”...

  14. The Fate of Nonvascularized Fat Grafts: Histological and Bioluminescent Study

    Directory of Open Access Journals (Sweden)

    Ataru Sunaga, MD

    2013-09-01

    Conclusions: Our study showed the process of survival and regeneration of nonvascularized fat grafts and suggested that graft-derived stromal cells proliferated within 7 days after transplantation and differentiated into adipocytes after postoperative week 3.

  15. Functionalisation of PAA radiation grafted PVDF

    International Nuclear Information System (INIS)

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

  16. Grafting of 2-butenyl acrylate onto starch

    International Nuclear Information System (INIS)

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

  17. Autologous miniature punch grafting in stable vitiligo

    Directory of Open Access Journals (Sweden)

    Rajagopal R

    2005-01-01

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

  18. Meshed split skin graft for extensive vitiligo

    Directory of Open Access Journals (Sweden)

    Srinivas C

    2004-05-01

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

  19. A tradable employment quota

    OpenAIRE

    Akyol, Metin; Neugart, Michael; Pichler, Stefan

    2015-01-01

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

  20. Wage-Employment Contracts

    OpenAIRE

    Kahn, Charles M.; Green, Jerry

    1983-01-01

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

  1. Argon-plasma-induced ultrathin thermal grafting of thermoresponsive pNIPAm coating for contractile patterned human SMC sheet engineering.

    Science.gov (United States)

    Rayatpisheh, Shahrzad; Li, Peng; Chan-Park, Mary B

    2012-07-01

    A new method for ultrathin grafting of pNIPAm on PDMS surfaces is introduced that employs plasma activation of the surface followed by thermal polymerization. This method is optimized for human primary SMC attachment and subsequent intact cell sheet detachment by lowering the temperature. The contractile gene expression of the cells showed that the contractile phenotype of the SMCs which is induced by aligning the cells through micropatterning is more preserved after thermoresponsive cell sheet detachment in contrast with enzymatic detachment. Given its simplicity and low cost, this thermoresponsive grafting method can be utilized for engineering patterned cell sheets for future bottom-up tissue engineering techniques. PMID:22535772

  2. Radiation grafted surfaces for solid phase synthesis 'effect of grafting depth on solid support performance'

    International Nuclear Information System (INIS)

    Solid phase synthesis (SPS) has developed rapidly throughout the last decade. Pharmaceutical companies have committed significant resources to the development of high throughput solid phase synthesis and combinatorial chemistry handling capabilities, which resulted in increased synthesis throughput for drug discovery research. The most widely used solid supports for SPS are based on cross-linked styrene-divinylbenzene resin (Merrifield resins) and their derivatives. However, with the increasing demand for reaction reproducibility, consistency of reaction kinetics and efficiency, as well as ease in parallel handling, the 'pellicular' type support is more attractive than traditional polystyrene resin for SPS. A pellicular solid support consists of a polymer, such as polystyrene, grafted to a rigid plastic such as a polyolefin or fluorinated polymer. A series of 'pellicular' type supports were fabricated by direct gamma radiation mediated graft polymerisation of styrene onto polypropylene, followed by functionalization (aminomethylation). In this study, we report the effect of grafting conditions, which include polymer type, radiation dose rate and total dose, concentration of monomer and solvents on the grafting depth profile and coupling reaction rates of functionalisation polystyrene grafted polypropylene surfaces. Confocal Raman spectroscopy was used for measuring the level of penetration of polystyrene graft into polypropylene and other structural features such as density of graft and depth of functionalization. Raman spectroscopy results showed that the calculated rate coefficient for coupling of Fmoc-labelled amino acids was primarily dependent on graft thickness, but was also influenced by the proportion of polystyrene graft to polypropylene. In general, it was also shown that with increasing loading capacity of the support the calculated rate coefficient for amino acid coupling decreased correspondingly. In addition, a new approach was used to prepare a high surface area support that had both a high rate coefficient and a high loading capacity

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-02-19

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

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

    Scientific Electronic Library Online (English)

    M., Abbasian; S. Esmaeily, Shoja.

    2012-06-01

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

  5. Autologous Fat Grafting for Whole Breast Reconstruction

    Directory of Open Access Journals (Sweden)

    Benjamin H. L. Howes, MBBS

    2014-03-01

    Full Text Available Summary: This is the first reported case of a patient who had a single-stage large-volume breast reconstruction with autologous fat grafting, following rotation flap approach (RoFA mastectomy. The purpose of this case study was to evaluate the viability of reconstruction of the breast by autologous fat grafting alone, in the context of RoFA mastectomy. The hypothesis was that there would be minimal interval loss of autologous fat on the whole breast reconstruction side. Right RoFA mastectomy was used for resection of an invasive primary breast cancer and resulted in the right breast skin envelope. Eleven months later, the patient underwent grafting of 400?ml of autologous fat into the skin envelope and underlying pectoralis major muscle. Outcome was assessed by using a validated 3D laser scan technique for quantitative breast volume measurement. Other outcome measures included the BREAST-Q questionnaire and 2D clinical photography. At 12-month follow-up, the patient was observed to have maintenance of volume of the reconstructed breast. Her BREAST-Q scores were markedly improved compared with before fat grafting, and there was observable improvement in shape, contour, and symmetry on 2D clinical photography. The 2 new techniques, RoFA mastectomy and large-volume single-stage autologous fat grafting, were used in combination to achieve a satisfactory postmastectomy breast reconstruction. Novel tools for measurement of outcome were the 3D whole-body laser scanner and BREAST-Q questionnaire. This case demonstrates the potential for the use of fat grafting for reconstruction. Outcomes in a larger patient populations are needed to confirm these findings.

  6. Comparison of Right and Left Grafts in Renal Transplantation

    OpenAIRE

    Salehipour Mehdi; Bahador Ali; Jalaeian Hamed; Salahi Heshmatollah; Nikeghbalian Saman; Khajehee Fardin; Malek-Hosseini Seyed

    2008-01-01

    This study compares outcomes and graft function of right and left grafts of deceased donor. We studied 120 kidney recipients from 60 deceased donors in Shiraz organ transplantation center from 1988 to 2004. We analyzed data regarding age, gender, side of grafts, duration of pre-transplant dialysis, hospital stay, serial creatinine levels, cold ischemic time, complications, graft function, patient survival rates, and post-operative complications. Recipients were divided into two groups: group ...

  7. On healing of titanium implants in iliac crest bone grafts

    OpenAIRE

    Sjöström, Mats

    2006-01-01

    Bone grafts and titanium implants are commonly used for surgical/prosthetic rehabilitation of the atrophic edentulous maxilla. The factors which influence bone graft healing and implant integration are not sufficiently understood. The aim of this dissertation was to evaluate autogenous bone grafting and delayed placement of titanium endosteal implants for reconstruction of the atrophic maxilla, including the effects of different patient factors on bone graft healing and integration of titaniu...

  8. Sulfonated hydrocarbon graft architectures for cation exchange membranes

    DEFF Research Database (Denmark)

    Nielsen, Mads Møller; Jankova Atanasova, Katja; Hvilsted, Søren

    2013-01-01

    A synthetic strategy to hydrocarbon graft architectures prepared from a commercial polysulfone and aimed as ion exchange membrane material is proposed. Polystyrene is grafted from a polysulfone macroinitiator by atom transfer radical polymerization, and subsequently sulfonated with acetyl sulfate to various degrees. Series of grafting densities and graft lengths are prepared, and membranes are solvent cast from DMSO. The membrane properties in aqueous environments are evaluated from their water ...

  9. The 5-Strand Hamstring Graft in Anterior Cruciate Ligament Reconstruction

    OpenAIRE

    Lee, Rushyuan Jay; Ganley, Theodore J.

    2014-01-01

    The use of anterior cruciate ligament reconstruction in the pediatric and adolescent population has been increasing in recent years. Autograft hamstring graft is favored in this population, but these patients often have smaller hamstring tendons that yield smaller final graft constructs. These smaller grafts are associated with an increased need for revision surgery. We describe a technique for obtaining a larger-diameter anterior cruciate ligament graft construct from autologous hamstring gr...

  10. Polymer structure formed in radiation-induced graft polymerization. II

    International Nuclear Information System (INIS)

    Methyl methacrylate was grafted onto viscose rayon, wood pulp, cellophane, and poly(vinyl alcohol) with preirradiation techniques using ?-rays from a 60Co source, and the stereoregularities of the grafted polymers separated from the trunk polymers and homopolymers were determined. The stereoregularity of the polymers grafted onto rayons is different from that of the polymers grafted onto wood pulp, mercerized wood pulp, cellophane, and poly(vinyl alcohol), confirming our previous results

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

    International Nuclear Information System (INIS)

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

  12. Sport climbing with pre-existing cardio-pulmonary medical conditions.

    Science.gov (United States)

    Kuepper, T; Morrison, A; Gieseler, U; Schoeffl, V

    2009-06-01

    Over the past 25 years sport climbing has developed from an elite extreme sport subculture pursued by few into a mainstream recreational sport enjoyed globally by climbers of all ages, climbing abilities, and with pre-existing health conditions. As the demands and grades of climbing difficulty have increased over this period, most scientific literature on sport climbing focused on acute injuries and overuse syndromes, or performance physiology in healthy adult males. The physiological response to sport climbing is more similar to that of resistance training (i.e., body building) rather than a predominantly aerobic sport (i.e., running, cycling), so that heart rate and blood pressure during a climb will be disproportionately high relative to the 'exercise' of climbing, and breathing may be irregular. Therefore this review sought evidence-based recommendations for recreational sport climbing participation by those individuals with pre-existing cardiopulmonary medical conditions including coronary heart disease, chronic heart failure, cardiac dysrhythmia, pulmonary diseases (i.e., asthma) or hypertension. This review defines the criteria that must be fulfilled for safe sport climbing by those with pre-existing cardiopulmonary conditions or those with hypertension. PMID:19199210

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

    Directory of Open Access Journals (Sweden)

    Kambiz Alizadeh

    2014-02-01

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

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

    DEFF Research Database (Denmark)

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

    2013-01-01

    A coprological survey was conducted to investigate the prevalence of parasites infect-ing hunting dogs with no history of recent anthelmintic treatments and with no overtclinical manifestations of cardiopulmonary or gastrointestinal illness. The hunting dogswere recruited from four different areas in Denmark, and fecal samples were obtainedin October and November, 2007. For detecting gastrointestinal parasites, samples (N = 178)were examined by a commercial flotation kit (Fecalyzer®EVSCO, USA). For detection of car-diopulmonary parasites, samples (N = 181) were collected on three consecutive days andexamined using the Baermann method. Parasites were recovered from 22.1% of the huntingdogs: Angiostrongylus vasorum (2.2%), Toxocara canis (12.4%), Uncinaria stenocephala (7.3%),Taenia spp. (1.7%), Toxascaris leonina (0.6%), Coccidia (0.6%) and unidentified trematode eggs(1.1%). Infection with only one species of parasite was more common (89.5%) than infectionwith two species (10.5%). A multiple logistic regression model showed that prevalence ofintestinal parasites was not influenced by age, gender or breed in adult dogs. There was asignificantly higher prevalence of intestinal parasites in the densely populated area of theisland Zealand compared with the less populated regions of the peninsular Jutland. Thepresent study reports the first case of A. vasorum in a dog from Jutland. The dog had beenvisiting the endemic area of western Zealand, suggesting that translocation of sub-clinicallyinfected dogs may contribute to introduction of A. vasorum into non-endemic areas.

  15. Cardiac magnetic resonance imaging in a patient with amniotic fluid embolism associated with severe cardiopulmonary complications.

    Science.gov (United States)

    Hosoya, Yumiko; Watanabe, Masafumi; Terashima, Masahiro; Amiya, Eisuke; Nakao, Tomoko; Hasegawa, Akiko; Hyodo, Hironobu; Ando, Jiro; Fujii, Tomoyuki; Nagai, Ryozo; Komuro, Issei

    2013-01-01

    Amniotic fluid embolism (AFE) is a rare but devastating complication of pregnancy. Acute circulatory failure and obstetric disseminated intravascular coagulopathy are often associated with AFE and lead to poor prognosis of this syndrome. Although many reports of AFE and its cardiopulmonary complications exist, their etiology remains unknown. Classically, it was believed that the fatal cardiopulmonary complication in AFE is due to acute and severe pulmonary hypertension caused by critical obstruction of the pulmonary vessels by embolized amniotic fluid. However, recent hypotheses are suggesting that anaphylactic reaction or a cytokine effect induced by amniotic fluid is the main pathophysiological mechanism. We report a case in which cardiac magnetic resonance imaging was performed at the chronic stage of AFE. Late gadolinium enhancement (LGE) was detected at the mid-wall of the left ventricle with no evidence of pulmonary hypertension. This finding suggests that the pathophysiological mechanism of severe cardiac complications in AFE may include direct left ventricular myocardial injury through an immune reaction or cytokine release, rather than pulmonary embolism. PMID:23676374

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

    Directory of Open Access Journals (Sweden)

    S. BAGCHI

    2001-01-01

    Full Text Available The mechanisms underlying the action of Indian red scorpion Buthus tamulus (BT venom-induced augmentation of cardiopulmonary reflexes elicited by intravenous injection of 5-HT were examined in urethane anaesthetized rats. The 5-HT produced a concentration-dependent increase in time-response area of bradycardiac response, with the responses at submaximal concentrations shifted to the left after exposure to BT venom (20 µg/kg, IV. Aprotinin (6000 kallikrein inactivating unit, IV as such had no effect on 5-HT reflex responses (bradycardia, hypotension, and apnea, but blocked the venom-induced reflex augmentation. While ondansetron (10 µg/kg, IV completely blocked the 5-HT reflex responses, these reappeared partially after venom exposure (20 µg/kg. Exposure to bradykinin (50 µg/kg, IV for 30 min also augmented the 5-HT-induced reflex responses similar to venom. The bradykinin-induced augmentation was also blocked by ondansetron. Results indicate that the venom-induced augmentation of cardiopulmonary reflexes is mediated through kinins sensitizing 5-HT3 receptor subtypes.

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

    Scientific Electronic Library Online (English)

    Carlos, Serrano; Mauricio Rocha e, Silva.

    Full Text Available Research in the field of cardiopulmonary disease in Brazil has been very active in recent decades. The combination of PUBMED, SCieLO, open access and online searching has provided a significant increase in the visibility of Brazilian journals. This newly acquired international visibility has in turn [...] resulted in the appearance of more original research reports in the Brazilian scientific press. This review is intended to highlight part of this work for the benefit of the readers of "Clinics." We searched through PUBMED for noteworthy articles published in Brazilian medical journals included in the Journal of Citation Reports of the Institute of Scientific Information to better expose them to our readership. The following journals were examined: "Arquivos Brasileiros de Cardiologia," "Arquivos Brasileiros de Endocrinologia e Metabologia," "Brazilian Journal of Medical and Biological Reviews," "Jornal Brasileiro de Pneumologia," "Jornal de Pediatria," "Revista Brasileira de Cirurgia Cardiovascular," "Revista da Associação Médica Brasileira," Revista da Escola de Enfermagem U.S.P." and "São Paulo Medical Journal." These journals publish original investigations in the field of cardiopulmonary disease. The search produced 71 references, which are briefly examined.

  18. Cardiopulmonary resuscitation beyond the technique / Reanimación cardiopulmonar más allá de la técnica

    Scientific Electronic Library Online (English)

    Fritz E, Gempeler R.

    2015-04-01

    Full Text Available En este artículo de reflexión se presenta el estado actual de la reanimación cardiopulmonar (RCP) y su revisión bioética. Se parte de la poca efectividad de RCP y las razones por las cuales hoy en día es un procedimiento de aplicación universal, en ocasiones sin tener en cuenta el estado o deseos de [...] l paciente. Se presentan posibles caminos de acción para el mejoramiento continuo de la reanimación cardiopulmonar especialmente desde el punto de vista humanístico. Se incita a una mayor participación de los pacientes y sus familiares en las decisiones medicas, especialmente en la planeación del manejo medico mas que en el momento agudo de la enfermedad, como es el caso de la RCP. Abstract in english This reflective article presents the current state of cardiopulmonary resuscitation (CPR) and reviews it from a bioethical standpoint. It starts with the ineffectiveness of CPR and the reasons why today it is a universally applied procedure, sometimes without taking into consideration the wishes or [...] condition of the patient. Possible courses of action for the continuous improvement of cardiopulmonary resuscitation are proposed, especially from the humanistic point of view. Greater involvement of patients and their families in medical decisions, particularly in the planning of medical management rather than in the acute phase of the disease-as is the case for CPR-is encouraged.

  19. Nontraumatic postmortem computed tomographic demonstration of cerebral gas embolism following cardiopulmonary resuscitation

    International Nuclear Information System (INIS)

    The aim of this study was to investigate cerebral gas embolism (GE) on nontraumatic postmortem CT (PMCT), regarding its frequency, location (arterial or venous), and causes. Our subjects were 404 nontraumatically deceased patients who had been in a state of cardiopulmonary arrest on arrival at our emergency room. PMCT was performed within 2 h of the confirmation of death. Cardiopulmonary resuscitation (CPR) was performed on 387 of the 404 subjects; and of these, cerebral GE was detected in 29 (7.5%) subjects (3 arterial, 25 venous, 1 undeterminable). Cerebral GE was not noted in the other 17 of the 404 subjects who did not undergo CPR. However, there was no significant difference in the incidence of cerebral GE between the subjects who underwent CPR and those who did not. The mechanism of cerebral arterial GE was presumed due to pulmonary barotrauma and/or paradoxical embolism, while the thoracic pump theory was suggested to explain the cerebral venous GE. Cerebral arterial/venous GE is found in CPR cases on nontraumatic PMCT. (author)

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

    Directory of Open Access Journals (Sweden)

    G.F. Stegmann

    1999-07-01

    Full Text Available Xylazine, midazolam and a midazolam / ketamine combination were administered to 6 goats in a randomised 3-way block design. All goats received all treatments with at least a 7-day interval between treatments. Statistically significant (P < 0.05 changes were observed in some of the measured cardiopulmonary variables for xylazine and midazolam/ ketamine. Xylazine administration resulted in statistically significant decreases in minute volume, arterial partial pressure of oxygen, heart rate andmeanarterial blood pressure. The increase in arterial partial pressure of carbon dioxide was not statistically significant. For the midazolam / ketamine combination, the decrease in tidal volume was statistically significant, but not the decrease in minute volume and increase in arterial partial pressure of carbon dioxide. The decrease in the arterial partial pressure of oxygen was also statistically significant. The mean arterial blood pressure for the combination was statistically significantly higher compared to xylazine. The changes in cardiopulmonary variables after midazolam administration were not statistically significant, such as tidal and minute volume, arterial partial pressure of oxygen and carbon dioxide. However, clinically significant effects such as hypoventilation and hypoxia were observed after its administration. The change in mean arterial blood pressure was minimal.

  1. Submaximal cardiopulmonary exercise testing predicts 90-day survival after liver transplantation.

    Science.gov (United States)

    Prentis, James M; Manas, Derek M D; Trenell, Michael I; Hudson, Mark; Jones, David J; Snowden, Chris P

    2012-02-01

    Liver transplantation has a significant early postoperative mortality rate. An accurate preoperative assessment is essential for minimizing mortality and optimizing limited donor organ resources. This study assessed the feasibility of preoperative submaximal cardiopulmonary exercise testing (CPET) for determining the cardiopulmonary reserve in patients being assessed for liver transplantation and its potential for predicting 90-day posttransplant survival. One hundred eighty-two patients underwent CPET as part of their preoperative assessment for elective liver transplantation. The 90-day mortality rate, critical care length of stay, and hospital length of stay were determined during the prospective posttransplant follow-up. One hundred sixty-five of the 182 patients (91%) successfully completed CPET; this was defined as the ability to determine a submaximal exercise parameter: the anaerobic threshold (AT). Sixty of the 182 patients (33%) underwent liver transplantation, and the mortality rate was 10.0% (6/60). The mean AT value was significantly higher for survivors versus nonsurvivors (12.0 ± 2.4 versus 8.4 ± 1.3 mL/minute/kg, P 9.0 mL/minute/kg. The predictive value was improved when the ideal weight was substituted for the actual body weight of a patient with refractory ascites, even after a correction for the donor's age. In conclusion, the preoperative cardiorespiratory reserve (as defined by CPET) is a sensitive and specific predictor of early survival after liver transplantation. The predictive value of CPET requires further evaluation. PMID:21898768

  2. Serum copper concentration as an index of cardiopulmonary injury in monocrotaline-treated rats.

    Science.gov (United States)

    Molteni, A; Ward, W F; Ts'ao, C H; Fitzsimons, E J

    1988-01-01

    The pyrrolizidine alkaloid monocrotaline produces pulmonary inflammation, hemorrhage, fibrosis, and hypertension. In rats, monocrotaline pneumotoxicity can be ameliorated by cotreatment with inhibitors of angiotensin converting enzyme (ACE), such as CL242817. In the present study, serum and urine copper (Cu) concentrations were evaluated as indices of cardiopulmonary injury in rats sacrificed after six weeks of continuous administration of monocrotaline (0 to 3.6 mg per kg per day, in the drinking water) or CL242817 (60 mg per kg per day, in the feed), or both. Monocrotaline-treated rats exhibited dose-dependent increases in (1) pulmonary histopathology, (2) pulmonary endothelial dysfunction (decreased lung plasminogen activator activity, and increased prostacyclin and thromboxane production), (3) pulmonary hydroxyproline (collagen) content, and (4) cardiac right ventricular hypertrophy (an anatomic correlate of pulmonary hypertension). The severity of cardiopulmonary damage was accompanied by a dose-dependent elevation in serum Cu concentration. Serum iron concentration, in contrast, did not change. Urinary Cu concentration correlated roughly with that of serum, but the variability within groups was high. Cotreatment with the ACE inhibitor CL242817 not only ameliorated monocrotaline-induced right heart enlargement and lung hydroxyproline accumulation but also reduced the hypercupremia in monocrotaline-treated rats. Thus, serum copper concentration appears to be an accurate and minimally invasive index of monocrotaline pneumotoxicity in this model of pulmonary hypertension. PMID:3149170

  3. Graft Union Formation in Tomato Plants: Peroxidase and Catalase Involvement

    OpenAIRE

    FERNÁNDEZ?GARCÍA, NIEVES; CARVAJAL, MICAELA; OLMOS, ENRIQUE

    2004-01-01

    • Background and Aims The use of grafted plants in vegetable crop production is now being expanded greatly. However, few data are available on the formation of graft unions in vegetables. In this work, the structural development of the graft union formation in tomato plants is studied, together with the possible relationship with activities of peroxidases and catalases.

  4. How does fat survive and remodel after grafting?

    Science.gov (United States)

    Mashiko, Takanobu; Yoshimura, Kotaro

    2015-04-01

    Autologous fat grafting has become an important procedure for volumization and revitalization, although clinical outcomes depend greatly on technique. It was revealed recently how grafted fat tissue survives, regenerates, or dies. Experimental results provided the underlying mechanism and clinical implications for therapeutic strategies to maximize the effects of fat grafting, minimize necrosis, and avoid oil cyst formation. PMID:25827562

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

    International Nuclear Information System (INIS)

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

  6. Acute and subacute effects of urban air pollution on cardiopulmonary emergencies and mortality: time series studies in Austrian cities.

    Science.gov (United States)

    Neuberger, Manfred; Moshammer, Hanns; Rabczenko, Daniel

    2013-10-01

    Daily pollution data (collected in Graz over 16 years and in the Linz over 18 years) were used for time series studies (GAM and case-crossover) on the relationship with daily mortality (overall and specific causes of death). Diagnoses of patients who had been transported to hospitals in Linz were also available on a daily basis from eight years for time series analyses of cardiopulmonary emergencies. Increases in air pollutant levels over several days were followed by increases in mortality and the observed effects increased with the length of the exposure window considered, up to a maximum of 15 days. These mortality changes in Graz and Linz showed similar patterns like the ones found before in Vienna. A significant association of mortality could be demonstrated with NO2, PM2.5 and PM10 even in summer, when concentrations are lower and mainly related to motor traffic. Cardiorespiratory ambulance transports increased with NO2/PM2.5/PM10 by 2.0/6.1/1.7% per 10 µg/m³ on the same day. Monitoring of NO2 (related to motor traffic) and fine particulates at urban background stations predicts acute effects on cardiopulmonary emergencies and extended effects on cardiopulmonary mortality. Both components of urban air pollution are indicators of acute cardiopulmonary health risks, which need to be monitored and reduced, even below current standards. PMID:24157504

  7. Acute and Subacute Effects of Urban Air Pollution on Cardiopulmonary Emergencies and Mortality: Time Series Studies in Austrian Cities

    Directory of Open Access Journals (Sweden)

    Daniel Rabczenko

    2013-10-01

    Full Text Available Daily pollution data (collected in Graz over 16 years and in the Linz over 18 years were used for time series studies (GAM and case-crossover on the relationship with daily mortality (overall and specific causes of death. Diagnoses of patients who had been transported to hospitals in Linz were also available on a daily basis from eight years for time series analyses of cardiopulmonary emergencies. Increases in air pollutant levels over several days were followed by increases in mortality and the observed effects increased with the length of the exposure window considered, up to a maximum of 15 days. These mortality changes in Graz and Linz showed similar patterns like the ones found before in Vienna. A significant association of mortality could be demonstrated with NO2, PM2.5 and PM10 even in summer, when concentrations are lower and mainly related to motor traffic. Cardiorespiratory ambulance transports increased with NO2/PM2.5/PM10 by 2.0/6.1/1.7% per 10 µg/m³ on the same day. Monitoring of NO2 (related to motor traffic and fine particulates at urban background stations predicts acute effects on cardiopulmonary emergencies and extended effects on cardiopulmonary mortality. Both components of urban air pollution are indicators of acute cardiopulmonary health risks, which need to be monitored and reduced, even below current standards.

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

    LENUS (Irish Health Repository)

    McCaul, Conán

    2009-10-01

    Multiple interventions have been tested in models of cardiopulmonary resuscitation (CPR) to optimize drug use, chest compressions, and ventilation. None has studied the effects of positive end-expiratory pressure (PEEP) on outcome. We hypothesized that because PEEP can reverse pulmonary atelectasis, lower pulmonary vascular resistance, and potentially improve cardiac output, its use during CPR would increase survival.

  9. Comparative Cardiopulmonary Toxicity of exhausts from Soy-Based Biofuels and Diesel in Healthy and Hypertensive Rats

    Science.gov (United States)

    Increased use of renewable energy sources raise concerns about health effects of new emissions. We analyzed relative cardiopulmonary health effects of exhausts from (1) 100% soy biofuel (B100), (2) 20% soy biofuel + 80% low sulfur petroleum diesel (B20), and (3) 100% petroleum di...

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

    OpenAIRE

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

    2013-01-01

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

  11. EFFECTS OF INHALATION OF SOLUBLE METALLIC CONSTITUENTS OF PARTICULATE MATTER ON CARDIOPULMONARY, THERMOREGULATORY, AND BIOCHEMICAL PARAMETERS IN GUINEA PIGS

    Science.gov (United States)

    EFFECTS OF INHALATION OF SOLUBLE METALLIC CONSTITUENTS OF PARTICULATE MATTER ON CARDIOPULMONARY, THERMOREGULATORY, AND BIOCHEMICAL PARAMETERS IN GUINEA PIGS. JP Nolan1, LB Wichers2, J Stanek3, UP Kodavanti1, MCJ Schladweiler1, PA Evansky1, ER Lappi1, DL Costa1, and WP Watkinson1...

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

    Scientific Electronic Library Online (English)

    GUO-QUAN, ZHU.

    2010-06-01

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

  13. Reconstruction of the anterior cruciate ligament: a comparison between bone-patellar tendon-bone grafts and fourstrand hamstring grafts

    OpenAIRE

    Razi, Mohammad; Sarzaeem, Mohammad Mahdi; Kazemian, Gholam Hossein; Najafi, Farideh; Najafi, Mohammad Amin

    2014-01-01

    Background: Disruption of anterior cruciate ligament (ACL) is a common ligamentous injury of the knee. The choice of graft for (ACL) reconstruction remains controversial. This prospective, randomized clinical trial aimed to compare clinical results of bone-patellar tendon-bone (BPTB) grafts and four-strand semitendinosus-gracilis (ST) grafts for ACL reconstruction over a 3-year follow-up interval.

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

    Scientific Electronic Library Online (English)

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

    2003-10-01

    Full Text Available INTRODUÇÃO: Os condutos de pericárdio bovino corrugado, processados em glutaraldeído, têm sido cada vez mais utilizados em cirurgia cardíaca para reconstrução da aorta. Têm constituído alternativa ao uso de outros materiais, com custo aceitável e com grande disponibilidade de formas e tamanhos. OBJE [...] TIVO: Analisar os resultados obtidos com o uso destes condutos de pericárdio bovino em operações de reconstrução aórtica, especialmente em relação a complicações tardias. MÉTODO: Estudo retrospectivo com 57 pacientes operados entre Janeiro de 1995 e Janeiro de 2002 submetidos aa reconstrução aórtica com uso de condutos de pericárdio bovino. Destes, 29 (50,8%) foram operados em condições de urgência ou emergência (predominantemente dissecções agudas de aorta Stanford A) e 28 em situações eletivas. Cinqüenta e quatro pacientes foram submetidos a esternotomia e circulação extracorpórea com abordagem da aorta ascendente com parada circulatória total e hipotermia profunda nas dissecções agudas e nos aneurismas de arco aórtico. Em três pacientes foi realizada toracotomia, para troca da aorta descendente (dois pacientes) e aortoplastia com "patch" (um paciente). RESULTADOS: A mortalidade hospitalar foi de 17,5%, sendo 7% nos eletivos e 27,5% nas urgências. O tempo de seguimento foi de 24,09 meses (intervalo de confiança 18,5:29,8 meses) e a sobrevida livre de complicações relacionadas aos condutos foi de 92,3% (EP±10,6 meses). Dois pacientes evoluíram com aneurisma tóraco-abdominal extenso secundário à dissecção de aorta que se esxtendia até as artérias ilíacas e um faleceu por endocardite na evolução tardia. Um paciente submetido a aortoplastia em aorta descendente evoluiu 42 meses após com dilatação local, sendo reoperado. Todos os demais pacientes encontram-se assintomáticos e reavaliados periodicamente por métodos de imagem, sem apresentarem alterações. CONCLUSÕES: O resultado pós-operatório foi adequado com índices de sobrevida adequados e compatíveis com a literatura. O uso de condutos de pericárdio bovino em operações de reconstrução aórtica se mostrou exeqüível e seguro, face ao baixo índice de complicações relacionadas ao material. Abstract in english INTRODUCTION: Glutaraldehyde-treated crimped bovine pericardial grafts are currently used in aortic graft surgery. These conduits have become good options for these operations, available in different sizes and shapes and at a low cost. OBJECTIVE:To evaluate the results obtained with bovine pericardi [...] al grafts for aortic reconstruction, specially concerning late complications. METHOD: Between January 1995 and January 2002, 57 patients underwent different types of aortic reconstruction operations using bovine pericardial grafts. A total of 29 (50.8%) were operated on an urgent basis (mostly acute Stanford A dissection) and 28 electively. Thoracotomy was performed in three patients for descending aortic replacement (two patients) and aortoplasty with a patch in one. All remaining 54 underwent sternotomy, cardiopulmonary bypass and aortic resection. Deep hypothermia and total circulatory arrest was used in acute dissections and arch operations. RESULTS: Hospital mortality was 17.5%. Follow-up was 24.09 months (18.5 to 29.8 months confidence interval) and complication-free actuarial survival curve was 92.3% (standard deviation ± 10.6). Two patients lately developed thoracoabdominal aneurysms following previous DeBakey II dissection and one died from endocarditis. One "patch" aortoplasty patient developed local descending aortic pseudoaneurysm 42 months after surgery. All other patients are asymptomatic and currently clinically evaluated with echocardiography and CT scans, showing no complications. CONCLUSION: Use of bovine pericardial grafts in aortic reconstruction surgery is adequate and safe, with few complications related to the conduits.

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

    DEFF Research Database (Denmark)

    Javakhishvili, Irakli; Tanaka, Masaru

    2012-01-01

    Graft copolymers composed of poly(2?methoxyethyl acrylate) are prepared employing controlled radical polymerization techniques. Linear backbones bearing atom transfer radical polymerization (ATRP) initiating sites are obtained by reversible addition–fragmentation chain transfer copolymerization of 2?methoxyethyl acrylate (MEA) and 2?(bromoisobutyryloxy)ethyl methacrylate (BriBuEMA) as well as 2?hydroxyethyl methacrylate and BriBuEMA in a controlled manner . MEA is then grafted from the linear macroinitiators by Cu (I)?mediated ATRP. Fairly high molecular weights (>120 000 Da) and low polydispersity indices (1.17–1.38) are attained. Thermal investigations of the graft copolymers indicate the presence of the freezing bound water, and imply that the materials may exhibit blood compatibility.

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

    DEFF Research Database (Denmark)

    Storb, Rainer; Gyurkocza, Boglarka

    2013-01-01

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

  17. Islet amyloid deposition limits the viability of human islet grafts but not porcine islet grafts

    OpenAIRE

    Potter, K.J.; Abedini, A.; Marek, P; Klimek, A. M.; Butterworth, S.; Driscoll, M; Baker, R.; Nilsson, M. R.; Warnock, G. L.; J. Oberholzer; Bertera, S.; Trucco, M.; Korbutt, G S; Fraser, P E; Raleigh, D P

    2010-01-01

    Islet transplantation is a promising treatment for diabetes but long-term success is limited by progressive graft loss. Aggregates of the beta cell peptide islet amyloid polypeptide (IAPP) promote beta cell apoptosis and rapid amyloid formation occurs in transplanted islets. Porcine islets are an attractive alternative islet source as they demonstrate long-term graft survival. We compared the capacity of transplanted human and porcine islets to form amyloid as an explanation for differences i...

  18. Stress – structure correlations in grafted polymer films

    OpenAIRE

    Lenz, Sebastian Cornelius

    2009-01-01

    In der vorliegenden Arbeit wurden experimentelle Untersuchungen zu gepfropften Polymerfilmen durchgeführt. Dabei wurden endgepfropfte poly-methyl-methacrylate (PMMA) Bürsten hergestellt durch „grafting from“ Methoden und polystyrol (PS)/ poly-vinyl-methyl-ether (PVME) Polymerfilme gepfropft auf UV sensitiven Oberflächen untersucht. Zur Strukturuntersuchung wurden die hergestellten Systeme wurden mit Rasterkraftmikroskopie (engl.: Surface Probe Microscopy, SPM), Röntgen - und Neutronenreflekti...

  19. Photoactivated surface grafting from PVDF surfaces

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-09-01

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

  20. Interposition Grafting of Large Extracranial Carotid Aneurysm

    OpenAIRE

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

    2011-01-01

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

  1. Photoactivated surface grafting from PVDF surfaces

    International Nuclear Information System (INIS)

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

  2. Activation, dissolution and controlled grafting of cellulose.

    Czech Academy of Sciences Publication Activity Database

    Raus, Vladimír; Látalová, Petra; Šturcová, Adriana; K?íž, Jaroslav; Janata, Miroslav; Dybal, Ji?í; Vl?ek, Petr

    Praha : Ústav makromolekulární chemie AV ?R, 2009. L7. ISBN 978-80-85009-60-6. [Workshop: Career in Polymers. 10.07.2009-11.07.2009, Prague] Institutional research plan: CEZ:AV0Z40500505 Keywords : cellulose * controlled grafting * controlled radical polymerization Subject RIV: CD - Macromolecular Chemistry

  3. Graft copolymers of cellulose with controlled architecture.

    Czech Academy of Sciences Publication Activity Database

    Raus, Vladimír; Látalová, Petra; Šturcová, Adriana; Dybal, Ji?í; K?íž, Jaroslav; Svobodová, Jana; Vl?ek, Petr

    Praha : Ústav makromolekulární chemie AV ?R, 2010. L_11. ISBN 978-80-85009-62-0. [Workshop "Career in Polymers" /2./. 23.07.2010-24.07.2010, Praha] Institutional research plan: CEZ:AV0Z40500505 Keywords : graft copolymers * cellulose * controlled architecture Subject RIV: CD - Macromolecular Chemistry

  4. Prefabricated Composite Graft for Eyelid Reconstruction.

    Science.gov (United States)

    Nicoletti, Giovanni; Jaber, Omar; Tresoldi, Marco Mario; Pellegatta, Tommaso; Faga, Angela

    2015-10-01

    The authors propose a prefabricated chondromucosal composite graft to reconstruct full-thickness defects of the lower eyelid. The technique was used in a patient suffering from a locally invasive basal cell carcinoma of the lower eyelid, who had previously undergone an extensive submucosal nasal septum resection. One week prior to the eyelid resection, the anterior skin surface of the auricular concha was replaced with a full-thickness oral mucosa graft. One week later, a full-thickness excision of the right lower eyelid was performed and the prefabricated chondromucosal auricular graft was used to restore the posterior lamella. The anterior lamella was reconstructed with a bipedicled myocutaneous flap from the upper eyelid. Because of the patient's scheduling needs, the medial pedicle of the flap was divided 28 days later and the lateral one after further 37 days. All the procedures were performed under local anesthesia. This technique adds a simple key detail to other time-honored reliable techniques, thus outlining an extremely convenient sequence for full-thickness eyelid reconstruction. The easily prepared prefabricated chondromucosal graft might be associated with any of the previously described flaps, thus providing a versatile and reliable method of posterior lamella reconstruction. PMID:26579869

  5. Cellular grafts in management of leucoderma

    Directory of Open Access Journals (Sweden)

    Mysore Venkataram

    2009-01-01

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

  6. Biocompatibility and occlusive efficiency of self-made aortic half-cycle stent-graft:an experimental study in dogs

    International Nuclear Information System (INIS)

    Objective: To explore the biocompatibility of self-made half-cycle stent-graft and the efficiency of occluding unilateral renal artery while retaining other branches of abdominal aorta in experimental dogs. Methods: Fifteen dogs were used in this study. The self-made aortic half-cycle stent-graft was 16 mm x 60 mm in size and the length of vascular-graft was 4 cm. Left or right renal arteries were occluded at random. Then angiography and enhanced spiral CT scan of abdominal aorta were performed. At 1, 4, 8, 12 and 16 weeks after operation, angiography and enhanced spiral CT scan were repeated in all dogs. The animals were sacrificed and aortic specimens were collected for pathological examination. The abdominal aortic specimens of normal aorta,naked stent area and stent-graft area were examined with both microscope and electronic microscope. Results: The self-made aortic half-cycle stent-graft was successfully placed in all 15 dogs. The occlusion site included right renal artery (n=7) and left renal artery (n =8), while other branches of aorta were spared. No vascular rupture occurred during the procedure. Postoperative angiography and CT scan showed that no displacement of the stent occurred, no blood flow was found in the occluded renal artery and other branches of aorta showed normal blood flow. At 16 weeks after operation,the thickness of intima of the normal aorta, naked stenting aorta and stent-grafts area was 85.7 ?m, 943.1 ?m and 2481.2?m respectively, while the thickness of the adjacent media was 1401.5 ?m, 615.1 ?m and 593.6?m respectively. The occluded kidney became smaller in size. Conclusion: The self-made aortic half-cycle stent-graft carries excellent biocompatibility and occlusive effect in experimental dogs, which might be employed in clinical practice to treat aortic dissection. (authors)

  7. Preparation and physical properties of grafted bagasse pulp metal complexes

    International Nuclear Information System (INIS)

    The effect of grafting on the electrical properties of bleached bagasse pulp has been investigated over a frequency range 1-200 Khz. The conductivity increases upon grafting with acrylic acid or acrylonitrile. Grafted bleached bagasse pulp with acrylic acid showed an increase in the dielectric constant ? and dielectric loss ?. The bagasse/acrylic acid copolymer metal complexes have shown further increase in the conductivity. The conductivity decreases as the degree of grafting increased from 25% to 215%, indicating slower rate of complexation at higher grafting percentage

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

    Directory of Open Access Journals (Sweden)

    Al Dayel Adel

    2001-01-01

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

  9. Rib Bone Graft Adjusted to Fit the Facial Asymmetry: A Frame Structure Graft.

    Science.gov (United States)

    Lee, Yoon Ho; Choi, Jong Hwan; Hwang, Kun; Choi, Jun Ho

    2015-10-01

    The authors introduce the concept of a "frame structure graft" in which a harvested rib bone was adjusted to fit facial asymmetry.On the costochondral junction of the sixth or seventh rib, a 5?cm incision was made. Through a subperiosteal dissection, the rib bone was harvested. Using a reciprocating saw, the harvested rib was scored on its anterior surface as well as its posterior surface with a partial depth at different intervals. The harvested rib bone was placed on the skin surface of the unaffected side of the face and a curvature was created exactly matching that of the unaffected side by bending the bone using a greenstick fracture. Thereafter, the graft was adjusted to conceal the asymmetry of the deficient side. The adjusted "frame structure" was transferred to the defect through the incisions on the affected side, and the "frame structure" graft was placed on the mandible or zygoma. The graft fixation was done externally with at least 2 Kirschner wires (K-wires).From January 2005 to August 2013, a total of 30 patients (13 men, 17 women, mean age 25.6 years) received a frame structure graft. All 30 patients achieved good healing at the operation site without complications. Donor-site morbidity as pneumothorax from the rib bone harvest was not found.Merits of this frame structure graft, the authors think, are that this method could allow a similar curvature to the normal side. In addition, the procedure itself is easy. PMID:26468802

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

    Directory of Open Access Journals (Sweden)

    Duara Rajnish

    2008-01-01

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

  11. Employment Protection and Migration

    OpenAIRE

    Bazillier, Rémi; Moullan, Yasser

    2012-01-01

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

  12. Assessing employment in Malta

    OpenAIRE

    Grech, Aaron George

    2003-01-01

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

  13. Why employment relations matter

    OpenAIRE

    Sisson, Keith

    2010-01-01

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

  14. Temporary employment and illness

    OpenAIRE

    Waenerlund, Anna-Karin

    2013-01-01

    Background: It is debated whether temporary employment compared to permanent employment entails an elevated risk of illness or not, as the empirical studies have not shown a unified picture. Since a significant part of the Swedish workforce is currently working under temporary employment contracts, it is important for public health research to pay close attention to what the implications in terms of illness might be. Therefore the aim of this thesis was to explore the relationship between tem...

  15. Development and validation of technique for in-vivo 3D analysis of cranial bone graft survival

    Science.gov (United States)

    Bernstein, Mark P.; Caldwell, Curtis B.; Antonyshyn, Oleh M.; Ma, Karen; Cooper, Perry W.; Ehrlich, Lisa E.

    1997-05-01

    Bone autografts are routinely employed in the reconstruction of facial deformities resulting from trauma, tumor ablation or congenital malformations. The combined use of post- operative 3D CT and SPECT imaging provides a means for quantitative in vivo evaluation of bone graft volume and osteoblastic activity. The specific objectives of this study were: (1) Determine the reliability and accuracy of interactive computer-assisted analysis of bone graft volumes based on 3D CT scans; (2) Determine the error in CT/SPECT multimodality image registration; (3) Determine the error in SPECT/SPECT image registration; and (4) Determine the reliability and accuracy of CT-guided SPECT uptake measurements in cranial bone grafts. Five human cadaver heads served as anthropomorphic models for all experiments. Four cranial defects were created in each specimen with inlay and onlay split skull bone grafts and reconstructed to skull and malar recipient sites. To acquire all images, each specimen was CT scanned and coated with Technetium doped paint. For purposes of validation, skulls were landmarked with 1/16-inch ball-bearings and Indium. This study provides a new technique relating anatomy and physiology for the analysis of cranial bone graft survival.

  16. Polypropylene grafted with glycidyl methacrylate using supercritical CO2 medium

    Scientific Electronic Library Online (English)

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

    2006-06-01

    Full Text Available Films of polypropylene (PP) were grafted with glycidil methacrylate (GMA) using supercritical CO2 as swelling agent and solvent. Different pressures and temperatures were used to study their effects on the soaking and grafting process. FTIR results showed signals at 1726 and 1640 cm-1, assigned to C [...] =O and C=C (after the soaking process), and a decreased signal at 1640 cm-1 (after the grafting procedure), suggesting the effective grafting of GMA. For the grafted material immersed in ethylenediamine, peaks in the 3600 to 3250 cm-1 range (N-H stretching) were evident. Contact angle measurements showed an increasingly hydrophilic nature in the direction from pure PP to grafted PP/GMA (PP-g-GMA) to PP-g-GMA immersed in ethylenediamine (PP-g-GMA/En). X-ray photoelectron spectroscopy provided evidenced of the effective incorporation of ethylenediamine in the grafted material.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1999-08-01

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

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

    International Nuclear Information System (INIS)

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

  19. Permeability of solutes through cellophanes grafted with vinyl monomers. II. Diffusion of potassium chloride through cellophanes grafted with acrylic acid

    International Nuclear Information System (INIS)

    The permeability behavior of potassium chloride through cellophane grafted with acrylic acid by a ?-irradiation method was studied by the theoretical equation derived from the phenomenological equation and compared with the results of Donnan membrane equilibrium. It was shown that the permeation of potassium chloride through the grafted cellophanes exhibited behavior typical of a polyionic membrane for grafts of more than 55% but depended on the permeability of both cellophane and graft regions for lower percents of grafting. It was found that the dominant factor affecting the permeation of potassium chloride was an effective concentration of fixed charge in the membrane. 5 figures, 2 tables

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

    DEFF Research Database (Denmark)

    Daugaard, Anders Egede; Jankova Atanasova, Katja

    2014-01-01

    Two new polymer grafts on an industrial grade multiwalled carbon nanotube (MWCNT) were prepared through a non-oxidative pathway employing controlled free radical polymerization for surface initiated polymer grafting. After photochemical introduction of an ATRP initiator onto the MWCNT, polymerizations of lauryl or stearyl acrylate were performed, resulting in two novel polymer modifications on the MWCNT (poly(lauryl acrylate) or poly(stearyl acrylate)). The method was found to give time dependent loading of polymers as a function of time (up to 38 wt% for both acrylates), and showed a plateau in loading after 12 h of polymerization. The modified nanomaterials were melt mixed into polypropylene composites with very low filler loading (0.3 wt%), whereafter both the thermal and electrical properties were investigated by DSC and dielectric resonance spectroscopy. The electrical properties were found to be substantially improved, where poly(lauryl acrylate) was found to be the superior surface modification, resulting in a conductive composite.

  1. Correlation of immunosuppression scheme with renal graft complications detected by dynamic renal scintigraphy

    International Nuclear Information System (INIS)

    Dynamic renal scintigraphy allows the diagnosis of complications in patients submitted to organ transplantation, such as perfusion abnormalities, acute tubular necrosis and rejection. In this study we employed 99m Tc-DTPA scintigraphy to study patients submitted to kidney transplantation. The results obtained and the clinical findings were conjunctively analyzed in order to detect graft rejection or other complications. The type of immunosuppressive scheme used was also correlated with the observed complications. Fifty-five patients submitted to kidney transplantation from 1989 to 1999 were evaluated. All patients with nephrotoxicity received a 3-drug immunosuppressive scheme. In this study, acute rejection was the most frequent complication (40.4%) observed following transplantation. Thirteen of 15 recipients of cadaveric kidney grafts presented acute tubular necrosis. Only one false-positive case was observed when scintigraphy and clinical findings were not concordant. We suggest carrying out renal scintigraphy to follow-up post-transplantation patients. (author)

  2. Radiographic Implications of Fat Grafting to the Reconstructed Breast.

    Science.gov (United States)

    Pinell-White, Ximena A; Etra, Joanna; Newell, Mary; Tuscano, Daymen; Shin, Kyungmin; Losken, Albert

    2015-09-01

    Autologous fat transfer is often used to smooth contour irregularities in the reconstructed breast. A potential concern with this technique is that it results in calcified lesions in the breast that can complicate subsequent cancer surveillance. The purpose of this review was to determine how fat grafting to the reconstructed breast impacts postoperative breast imaging. This is a matched cohort analysis of patients who underwent postmastectomy breast reconstruction with and without fat grafting as a secondary procedure. Nonfat grafted reconstructive patients were matched based on age, year of initial reconstruction, and type of reconstruction. Postoperative imaging at our institution was required for inclusion. The two groups were compared in terms of incidence and distribution of radiographic studies performed in follow-up and the need for biopsies. Fifty-one reconstructed breasts with a history of fat grafting were compared to 51 nonfat grafted, reconstructed breasts. The fat grafted group underwent a total of 204 breast imaging studies over a mean follow-up of 4.2 years, while the nonfat grafted group underwent 167 studies over 4.1 years (p = 0.21). More mammograms, ultrasounds, and magnetic resonance images were performed after fat grafting, but a significant difference was evident only for mammography (34 versus 12, p = 0.05). The incidence of breast biopsy to clarify abnormal imaging was nonsignificantly higher in the fat grafted group (17.6% versus 7.8%, p = 0.14). Fewer than 10 percent of imaging studies in the fat grafted cohort were performed to investigate a clinical or radiographic abnormality occupying the same breast quadrant as prior fat injection. Breast cancer patients treated with fat grafting required more breast imaging and biopsies than their nonfat grafted counterparts, but the areas of suspicion poorly corresponded to the site of prior fat grafting. Multimodal breast reconstruction may drive the additional diagnostic burden and not the fat grafting technique itself. PMID:26133468

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

    Science.gov (United States)

    Shimko, Daniel Andrew

    2004-12-01

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

  4. Employment Discrimination: A Survey.

    Science.gov (United States)

    Caplan, Gerald A.

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

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

    Scientific Electronic Library Online (English)

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

    2013-10-01

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

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

    Directory of Open Access Journals (Sweden)

    Conboy Gary

    2010-07-01

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

  7. [Cardiopulmonary exercise testing and dyspnea in patients with chronic respiratory diseases].

    Science.gov (United States)

    De Jesus, A M; Chabrol, J; Aguilaniu, B; Wallaert, B

    2014-10-01

    Cardiopulmonary exercise testing (CPET) is the most comprehensive investigation for understanding the mechanisms responsible for dyspnea in patients with chronic respiratory disease. The two observations presented here illustrate how CPET can contribute to the management of patients with interstitial lung diseases. A 60-year-old woman had been followed for 20 years for non-progressive pulmonary sarcoidosis, untreated for many years. CPET led to the diagnosis of an atrial septal defect. A 76-year-old man was treated for idiopathic pulmonary fibrosis. Before pulmonary rehabilitation, CPET was performed which revealed significant aortic valve stenosis, which had been to that point asymptomatic. In these two observations, CPET determined the presence of an associated disease, distinct from the interstitial lung disease. PMID:25391510

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

    Scientific Electronic Library Online (English)

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

    2012-03-01

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

  9. Management of a case of left tracheal sleeve pneumonectomy under cardiopulmonary bypass: Anesthesia perspectives

    Directory of Open Access Journals (Sweden)

    Aman Jyoti

    2014-01-01

    Full Text Available The lung tumors with carinal involvement are frequently managed with tracheal sleeve pneumonectomy and tracheobronchial anastomosis without use of cardiopulmonary bypass (CPB. Various modes of ventilation have been described during tracheal resection and anastomosis. Use of CPB during this period allows the procedure to be conducted in a more controlled way. We performed tracheal sleeve pneumonectomy for adenoid cystic carcinoma of left lung involving carina. The surgery was performed in two stages. In the first stage, left pneumonectomy was performed and in the second stage after 48 h, tracheobronchial resection and anastomosis was performed under CPB. Second stage was delayed to avoid excessive bleeding (due to heparinization from the extensive vascular raw area left after pneumonectomy. Meticulous peri-operative planning and optimal post-operative care helped in successful management of a complex case, which is associated with high morbidity and mortality.

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

    Scientific Electronic Library Online (English)

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

    2014-01-01

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

  11. Reference values for cardiopulmonary exercise testing in healthy adults: a systematic review.

    Science.gov (United States)

    Paap, Davy; Takken, Tim

    2014-12-01

    Reference values (RV) for cardiopulmonary exercise testing (CPET) provide the comparative basis for answering important questions concerning the normality of exercise response in patients and significantly impacts the clinical decision-making process. The aim of this study is to systematically review the literature on RV for CPET in healthy adults. A secondary aim is to make appropriate recommendations for the practical use of RV for CPET. Systematic searches of MEDLINE, EMBASE and PEDro databases up to March 2014 were performed. In the last 30 years, 35 studies with CPET RV were published. There is no single set of ideal RV; characteristics of each population are too diverse to pool the data in a single equation. Therefore, each exercise laboratory must select appropriate sets of RV that best reflect the characteristics of the population/patient tested, and equipment and methodology utilized. PMID:25418758

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

    LENUS (Irish Health Repository)

    Hargrove, M

    2008-07-01

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

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

    International Nuclear Information System (INIS)

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

  14. Significance of the carboxyhemoglobin level for out-of-hospital cardiopulmonary arrest

    Directory of Open Access Journals (Sweden)

    Youichi Yanagawa

    2012-01-01

    Full Text Available Background: At low concentrations, carbon monoxide (CO can confer cyto and tissue-protective effects, such as endogenous Heme oxygenase 1 expression, which has antioxidative, anti-inflammatory, antiproliferative, and antiapoptotic effects. The level of carboxyhemoglobin in the blood is an indicator of the endogenous production of CO and inhaled CO. Aim of study: To investigate the significance of the value of carboxyhemoglobin for out-of-hospital (OH cardiopulmonary arrest (CPA. Materials and Methods: This study involved a medical chart review of cases treated from January to December 2005. The inclusion criteria included a patient who was transported to this department due to an OH CPA. The exclusion criteria included a patient who did not undergo blood gas analysis on arrival and who experienced CPA due to acute carbon monoxide intoxication. The subjects were divided into two groups based on their final outcome of either survival or non-survival. Results: There was no significant difference associated with the sex, age, frequency of witness collapse, bystander cardiopulmonary arrest, electrocardiogram at scene, cause of CPA, value of PCO 2 , HCO3 - , and methemoglobin. The frequency of OH return of spontaneous circulation and the value of pH, PO 2 , base excess, and carboxyhemoglobin in the survival group were greater than those values in the non-survival group. There were no subjects whose carboxyhemoglobin level was 0% on arrival in the survival groups. Conclusion: There appeared to be an association between higher carboxyhemoglobin levels and survival in comparison with non-survival patients.

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

    Science.gov (United States)

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

    1993-01-01

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

  16. Pancreatic cellular injury after cardiac surgery with cardiopulmonary bypass: frequency, time course and risk factors.

    Science.gov (United States)

    Nys, Monique; Venneman, Ingrid; Deby-Dupont, Ginette; Preiser, Jean-Charles; Vanbelle, Sophie; Albert, Adelin; Camus, Gérard; Damas, Pierre; Larbuisson, Robert; Lamy, Maurice

    2007-05-01

    Although often clinically silent, pancreatic cellular injury (PCI) is relatively frequent after cardiac surgery with cardiopulmonary bypass; and its etiology and time course are largely unknown. We defined PCI as the simultaneous presence of abnormal values of pancreatic isoamylase and immunoreactive trypsin (IRT). The frequency and time evolution of PCI were assessed in this condition using assays for specific exocrine pancreatic enzymes. Correlations with inflammatory markers were searched for preoperative risk factors. One hundred ninety-three patients submitted to cardiac surgery were enrolled prospectively. Blood IRT, amylase, pancreatic isoamylase, lipase, and markers of inflammation (alpha1-protease inhibitor, alpha2-macroglobulin, myeloperoxidase) were measured preoperatively and postoperatively until day 8. The postoperative increase in plasma levels of pancreatic enzymes and urinary IRT was biphasic in all patients: early after surgery and later (from day 4 to 8 after surgery). One hundred thirty-three patients (69%) experienced PCI, with mean IRT, isoamylase, and alpha1-protease inhibitor values higher for each sample than that in patients without PCI. By multiple regression analysis, we found preoperative values of plasma IRT >or=40 ng/mL, amylase >or=42 IU/mL, and pancreatic isoamylase >or=20 IU/L associated with a higher incidence of postsurgery PCI (P < 0.005). In the PCI patients, a significant correlation was found between the 4 pancreatic enzymes and urinary IRT, total calcium, myeloperoxidase, alpha1-protease inhibitor, and alpha2-macroglobulin. These data support a high prevalence of postoperative PCI after cardiac surgery with cardiopulmonary bypass, typically biphasic and clinically silent, especially when pancreatic enzymes were elevated preoperatively. PMID:17438451

  17. Subarachnoid clonidine and trauma response in cardiac surgery with cardiopulmonary bypass

    Directory of Open Access Journals (Sweden)

    Claudia Gissi da Rocha Ferreira

    2014-12-01

    Full Text Available Background and objectives: The intense trauma response triggered by cardiopulmonary bypass can lead to increased morbidity and mortality. The present study evaluated whether clonidine, a drug of the class of ?-2 agonists, administered by spinal route, without association with local anesthetics or opioids, reduces this response in cardiac surgery with cardiopulmonary bypass. Method: A total of 27 patients between 18 and 75 years old, divided by non-blinded fashion into a control group (15 and a clonidine group (12, were studied. All patients underwent identical technique of general anesthesia. Then, only the clonidine group received 1 ?g kg?1 clonidine by spinal route. Levels of blood glucose, lactate and cortisol were measured at three consecutive times: T1, at the time of installation of invasive arterial pressure; T2, 10 min after the first dose for cardioplegia; and T3, at the time of skin suture; and troponin I values at T1 and T3. The variation of results between T2-T1, T3-T2, and T3-T1 was also evaluated. Results: There was a statistically significant difference only with respect to the variation in blood glucose in the clonidine group: T3-T2, p = 0.027 and T3-T1, p = 0.047. Conclusions: Spinal clonidine at a dose of 1 ?g kg?1 did not decrease blood measurements of troponin, cortisol, or lactate. Blood glucose suffered a more moderate variation during the procedure in the clonidine group. This fact, already reported in the literature, requires further investigation to be clarified.

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

    Science.gov (United States)

    Al-Sabi, Mohammad N S; Kapel, Christian M O; Johansson, Anna; Espersen, Mia C; Koch, Jørgen; Willesen, Jakob L

    2013-09-23

    A coprological survey was conducted to investigate the prevalence of parasites infecting hunting dogs with no history of recent anthelmintic treatments and with no overt clinical manifestations of cardiopulmonary or gastrointestinal illness. The hunting dogs were recruited from four different areas in Denmark, and fecal samples were obtained in October and November, 2007. For detecting gastrointestinal parasites, samples (N=178) were examined by a commercial flotation kit (Fecalyzer(®) EVSCO, USA). For detection of cardiopulmonary parasites, samples (N=181) were collected on three consecutive days and examined using the Baermann method. Parasites were recovered from 22.1% of the hunting dogs: Angiostrongylus vasorum (2.2%), Toxocara canis (12.4%), Uncinaria stenocephala (7.3%), Taenia spp. (1.7%), Toxascaris leonina (0.6%), Coccidia (0.6%) and unidentified trematode eggs (1.1%). Infection with only one species of parasite was more common (89.5%) than infection with two species (10.5%). A multiple logistic regression model showed that prevalence of intestinal parasites was not influenced by age, gender or breed in adult dogs. There was a significantly higher prevalence of intestinal parasites in the densely populated area of the island Zealand compared with the less populated regions of the peninsular Jutland. The present study reports the first case of A. vasorum in a dog from Jutland. The dog had been visiting the endemic area of western Zealand, suggesting that translocation of sub-clinically infected dogs may contribute to introduction of A. vasorum into non-endemic areas. PMID:23602361

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

    DEFF Research Database (Denmark)

    SØrensen, Marie Maagaard; Jensen, Mariann Tang

    2013-01-01

    BACKGROUND: During exercise cardiac function is often limited in patients with pectus excavatum. Therefore, we hypothesized that cardiopulmonary exercise function would improve after the Nuss procedure. METHODS: Seventy-five teenagers (49 patients, 26 controls) were investigated at rest and during bicycle exercise before surgery, and 1 year and 3 years postoperatively (after pectus-bar removal). Echocardiography and lung spirometry were performed at rest. Cardiac output, heart rate, and aerobic exercise capacity were measured using a photoacoustic gas-rebreathing technique during rest and exercise. RESULTS: Forty-four patients and 26 controls completed 3 years follow-up. Preoperatively, patients had lower maximum cardiac index, mean ±SD, 6.6 ± 1.2 l·min(-1)·m(-2) compared with controls 8.1 ± 1.0 l·min(-1)·m(-2) during exercise (p = 0.0001). One year and 3 years postoperatively, patients' maximum cardiac index had increased significantly and after 3 years there was no difference between patients and controls (8.1 ± 1.2 l·min(-1)·m(-2) and 8.3 ± 1.6 l·min(-1)·m(-2), respectively [p = 0.572]). The maximum oxygen consumption was unchanged. Left ventricular dimensions increased in patients over 3 years; however, no difference was seen between the 2 groups. Preoperatively, patients had lower forced expiratory volume in the first second of expiration (FEV1; 86% ± 13%) as compared with controls (94% ± 10%), p = 0.009. Postoperatively, no difference was found in FEV1 between the 2 groups. CONCLUSIONS: Before operation, FEV1 and maximum cardiac index were lower in patients compared with healthy, age-matched controls. One year after, both parameters had increased, although only FEV1 had normalized. After 3 years and bar removal, cardiopulmonary function in patients during exercise had normalized.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-07-01

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

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

    International Nuclear Information System (INIS)

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

  2. Novel anterior cruciate ligament graft fixation device reduces slippage

    Directory of Open Access Journals (Sweden)

    Lopez MJ

    2013-05-01

    Full Text Available Mandi J Lopez,1 Allen Borne,2 W Todd Monroe,3 Prakash Bommala,1 Laura Kelly,1 Nan Zhang11Laboratory for Equine and Comparative Orthopedic Research, Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, 2Louisiana State University, New Orleans Health Sciences Center, School of Medicine, New Orleans, 3Department of Biological and Agricultural Engineering, Agricultural Center, Louisiana State University, Baton Rouge, LA, USAAbstract: Clinically significant laxity occurs in 10%–30% of knees after anterior cruciate ligament reconstruction. Graft slippage and tension loss at the hamstring graft tibial fixation site during and after reconstruction surgery contribute to postoperative joint laxity and are detrimental to long-term knee stability and graft properties. Limiting graft slippage will reduce associated complications. We sought to compare the in vitro mechanical properties and in vivo joint stabilization, postoperative limb use, and graft incorporation of the novel GraftGrab™ (GG device designed to reduce hamstring graft tibial fixation slippage with the commercially available bioabsorbable Bio-Post™ and spiked washer (BP. Mechanical testing was performed on canine tibia-hamstring graft constructs to quantify initial fixation properties. In vivo joint stabilization, postoperative limb use and graft incorporation of hamstring graft reconstructions were determined in a canine model. Outcomes included tibial translation and ground reaction forces preoperatively and 4 and 8 weeks postoperatively, three-dimensional graft and bone tunnel dimensions at the latter two time points, and graft-bone microstructure, as well as mechanical properties 8 weeks after implantation. Immediately after fixation, all grafts slipped from the BP constructs versus about 30% of GG constructs. In vivo limb use remained low, and tibial translation increased with time in the BP cohort. These results together confirm that initial graft slippage is lower with GG versus BP extracortical hamstring graft tibial fixation. In addition, postoperative recovery and joint stability are more consistent with the GG. This information supports the GG as an alternative to extracortical tibial hamstring graft fixation that has procedural advantages over current implants and reduces graft failure from slippage.Keywords: cruciate, implant, bioabsorbable, canine, graft, tibia

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

    Directory of Open Access Journals (Sweden)

    Tomiak Tomasz

    2014-10-01

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

  4. The influence of propofol and midazolam/halothane anesthesia on hepatic SvO2 and gastric mucosal pH during cardiopulmonary bypass

    DEFF Research Database (Denmark)

    Christiansen, Christian Lindksov; Ahlburg, Peter; Jakobsen, Carl-Johan; Andresen, Else Bay; Paulsen, P K

    1998-01-01

    Because propofol is known to reduce vascular resistance, the objective of this study was to compare the indices of hepatosplanchnic circulation and oxygenation during cardiopulmonary bypass (CPB) in patients anesthetized with either propofol or midazolam/halothane.

  5. Successful treatment of fulminant pulmonary embolism with extracorporeal life support and simultaneous systemic thrombolytic therapy after 1 h of cardiopulmonary resuscitation.

    Science.gov (United States)

    Kamiya, Hiroyuki; Aubin, Hug; Akhyari, Payam; Walz, Roland; Saeed, Diyar; Miles-Kindgen, Detlef; Lichtenberg, Artur

    2015-12-01

    Here we describe a patient with a fulminant pulmonary embolism, who has been successfully treated with an extracorporeal life support system and simultaneous systemic thrombolytic therapy after 1 h of cardiopulmonary resuscitation. PMID:24214372

  6. Radiation-induced grafting of TMPM onto polypropylene

    International Nuclear Information System (INIS)

    The gamma radiation-induced graft copolymerization of 2,2,6,6-tetramethyl-4-piperidinyl-methacrylate (TMPM), a very effective hindered amine light stabilizer (HALS), onto polypropylene was investigated by simultaneous- irradiation technique. The various synthesis conditions on the graft content was studied. It was found that benzene, CCl4 and petroleum ether are more effective than other solvents, the percent grafting reached 7.1% for benzene. The percent grafting is higher when graft copolymerization is carried out in argon atmosphere than those in air. For all the grafting copolymerization carried out in benzene and CCl4, percent grafting increase linearly from 1 to 5 Mrad and beyond 5 Mrad, a tendency to level off appeared. At a constant dose, the percent grafting was found to be higher at high dose rate until 228 rad/s. Percent grafting also increased continuously with increasing monomer concentration up to 2.85 mol/L, but significant increase in grafting was observed only up to 1.14 mol/L

  7. Mussel-Inspired Artificial Grafts for Functional Ligament Reconstruction.

    Science.gov (United States)

    Li, Hong; Chen, Shiyi; Chen, Jiwu; Chang, Jiang; Xu, Mengchi; Sun, Yaying; Wu, Chengtie

    2015-07-15

    The development of an artificial graft with distinct osteogenetic activity to enhance osseointegration and to induce the formation of biomimetic tissue structure for ligament reconstruction remains a significant challenge. Inspired by mussels, biomimetic calcium phosphate apatite/polydopamine hybridized-polyethylene terephthalate (APA/PDA-PET) grafts were successfully prepared. The efficacy and mechanism of APA/PDA-PET grafts to induce osseointegration were systematically investigated. The results from the in vitro study indicated that the prepared APA/PDA-PET grafts support the attachment of bone marrow stromal cells (BMSCs) and stimulate the proliferation and osteogenic/angiogenic differentiation of BMSCs via activation of the PKC/p-ERK1/2 signaling pathway. In vivo, histological and radiological results further demonstrate that the APA/PDA-PET grafts significantly improve osseointegration by inducing the formation of new bone tissue and the fibrocartilage transitional zone compared with pure PET grafts. In addition, the pull-out strength of the APA/PDA-PET grafts is significantly higher than that of the pure PET grafts 12 weeks after surgery. These results suggest that this mussel-inspired biomimetic method is an effective strategy for modifying artificial grafts, and the prepared APA/PDA-PET grafts, which possess a beneficial interface, can significantly improve in vivo osseointegration for ligament reconstruction via the synergistic effect of polydopamine and apatite. PMID:26098135

  8. Electrospun vascular grafts with improved compliance matching to native vessels.

    Science.gov (United States)

    Nezarati, Roya M; Eifert, Michelle B; Dempsey, David K; Cosgriff-Hernandez, Elizabeth

    2015-02-01

    Coronary artery bypass grafting is one of the most commonly performed major surgeries in the United States. Autologous vessels such as the saphenous vein are the current gold standard for treatment; however, synthetic vascular prostheses made of expanded poly(tetrafluoroethylene) or poly(ethylene terephthalate) are used when autologous vessels are unavailable. These synthetic grafts have a high failure rate in small diameter (performance are focused on preventing intimal hyperplasia by fabricating grafts with compliance and burst pressure similar to native vessels. To this end, we have developed an electrospun vascular graft from segmented polyurethanes with tunable properties by altering material chemistry and graft microarchitecture. Relationships between polyurethane tensile properties and biomechanical properties were elucidated to select polymers with desirable properties. Graft thickness, fiber tortuosity, and fiber fusions were modulated to provide additional tools for controlling graft properties. Using a combination of these strategies, a vascular graft with compliance and burst pressure exceeding the saphenous vein autograft was fabricated (compliance?=?6.0?±?0.6%/mmHg × 10(-4) , burst pressure?=?2260?±?160 mmHg). This graft is hypothesized to reduce intimal hyperplasia associated with low compliance in synthetic grafts and improve long-term clinical success. Additionally, the fundamental relationships between electrospun mesh microarchitecture and mechanical properties identified in this work can be utilized in various biomedical applications. PMID:24846218

  9. The effect of carbon dioxide therapy on composite graft survival

    Scientific Electronic Library Online (English)

    Eliana Ferreira Ribeiro, Durães; Leonardo de Castro, Durães; Fabiana Pirani, Carneiro; Ruy de Souza, Lino Júnior; João Batista de, Sousa.

    2013-08-01

    Full Text Available PURPOSE: To investigate the effect of carboxytherapy in auricular composite grafts in rabbits. METHODS: An experimental study was conducted using 20 rabbits randomly assigned to a treatment group of carboxytherapy or a control group of saline solution. In each ear, a circular graft with 1.5 cm or 2 [...] cm of diameter was amputated and reattached. Animals underwent carbon dioxide or saline injection four times during the experiment. We analyzed clinical evolution of the animals, grafts survival, histopathology features and histomorphometry of collagen. RESULTS:The treated group had a significantly lower weight gain (p=0.038). Histopathology was not significantly different between groups. There was an increase in amount of collagen in 2 cm grafts submitted to carbon dioxide therapy (p=0.003). Carboxytherapy didn't influence graft survival rate for 1.5 cm grafts or 2 cm grafts (p=0.567 and p=0.777, respectively). CONCLUSIONS:Carbon dioxide therapy increased the amount of collagen in 2 cm grafts. CO2 was not significantly different from saline infusion on composite grafts survival, but this study suggests that there is a mechanical effect caused by distension which favored graft survival.

  10. Surgical complications after renal transplantation in grafts with multiple arteries

    Directory of Open Access Journals (Sweden)

    Eduardo Mazzucchi

    2005-04-01

    Full Text Available INTRODUCTION: Renal transplantation with multiple arteries appears, in literature, associated to a major index of surgical complications. This study compared the surgical complications and short-term outcome renal transplants with multiple arteries and single artery grafts. MATERIALS AND METHODS: The data of 64 renal transplants with multiple arteries performed between January 1995 and December 1999 were compared to the ones of 292 transplants with single renal artery. The aspects analyzed were number of arteries of the graft, donor type, vascular reconstruction technique, the occurrence of surgical complications, the incidence of delayed graft function, graft function 1 month after transplantation, graft loss and the patients' deaths. RESULTS: The incidence of surgical complications in grafts with multiple arteries and single renal artery was respectively: vascular - 3.1% and 3.1%; urological - 6.3% and 2.7% and other surgical complications - 15.6% and 10.6%, respectively. The incidence of lymphoceles was 3.1% in grafts with a single artery and 12.5% in grafts with more than 1 artery (p = 0.0015. The incidence of delayed graft function in grafts with multiple arteries and with a single renal artery was respectively 35.1 and 29.1% (p = 0.295. Mean serum creatinine at the 30th postoperative day was 2.46 and 1.81 in grafts with multiple and with 1 artery, respectively (p=0.271. CONCLUSIONS: Kidney transplantation using grafts with single and multiple arteries present similar indexes of surgical complications and short-term outcome; lymphoceles were more frequent among grafts with multiple arteries.

  11. Surgical complications after renal transplantation in grafts with multiple arteries

    Scientific Electronic Library Online (English)

    Eduardo, Mazzucchi; Auro A., Souza; Willian C., Nahas; Ioannis M., Antonopoulos; Affonso C., Piovesan; Sami, Arap.

    2005-04-01

    Full Text Available INTRODUCTION: Renal transplantation with multiple arteries appears, in literature, associated to a major index of surgical complications. This study compared the surgical complications and short-term outcome renal transplants with multiple arteries and single artery grafts. MATERIALS AND METHODS: Th [...] e data of 64 renal transplants with multiple arteries performed between January 1995 and December 1999 were compared to the ones of 292 transplants with single renal artery. The aspects analyzed were number of arteries of the graft, donor type, vascular reconstruction technique, the occurrence of surgical complications, the incidence of delayed graft function, graft function 1 month after transplantation, graft loss and the patients' deaths. RESULTS: The incidence of surgical complications in grafts with multiple arteries and single renal artery was respectively: vascular - 3.1% and 3.1%; urological - 6.3% and 2.7% and other surgical complications - 15.6% and 10.6%, respectively. The incidence of lymphoceles was 3.1% in grafts with a single artery and 12.5% in grafts with more than 1 artery (p = 0.0015). The incidence of delayed graft function in grafts with multiple arteries and with a single renal artery was respectively 35.1 and 29.1% (p = 0.295). Mean serum creatinine at the 30th postoperative day was 2.46 and 1.81 in grafts with multiple and with 1 artery, respectively (p=0.271). CONCLUSIONS: Kidney transplantation using grafts with single and multiple arteries present similar indexes of surgical complications and short-term outcome; lymphoceles were more frequent among grafts with multiple arteries.

  12. Improvement of tomato local varieties by grafting in organic farming

    Science.gov (United States)

    Moreno, Marta M.; Villena, Jaime; Moreno, Carmen; García, Arántzazu M.; Mancebo, Ignacio; Meco, Ramón

    2015-04-01

    Grafting is the union of two or more pieces of living plant tissue that grow as a single plant. The early use of grafted vegetables was associated with protected cultivation which involves successive cropping (Lee et al., 2010). For this reason, in the past, grafting was used with vegetable crops to limit the effects of soil-borne diseases. However, the reasons for grafting as well as the kinds of vegetable grafted have increased considerably over the years. In tomato (Solanum lycopersicum L.), one of the most important horticultural crops in the world, the effect of grafting has also been widely studied. These effects on commercial tomato varieties can be summarized in increasing plant vigor and crop yield or inducing tolerance to abiotic stresses, although the effects on tomato fruit quality or on the sensory properties are not so patent (David et al., 2008). However, a few studies about the effect of grafting on local tomato varieties, which are especially recommended for organic production in spite of their lower yields in many cases, have been developed. In this work we evaluated the effect of grafting on tomato local varieties under organic management using vigorous commercial rootstocks, and aspects related to vigor, yield and tomato fruit composition were analyzed. In general terms, grafting increased the plant vigor, the crop yield and the fruit antioxidant content, although no modification of morphological fruit attributes was observed. Keywords: grafting, Solanum lycopersicum L., local varieties, organic farming. References: Davis A.R., Perkins-Veazie P., Hassell R., Levi A., King S.R., Zhang X. 2008. Grafting effects on vegetable quality. HortScience 43(6): 1670-1671. Lee J.M., Kubota C., Tsao S.J., Bie Z., Hoyos-Echevarría P., Morra L., Oda M. 2010. Current status of vegetable grafting: Diffusion, grafting techniques, automation. Scientia Horticulturae 127: 93-105.

  13. Factors associated with extubation time in coronary artery bypass grafting patients

    Science.gov (United States)

    Rezaianzadeh, Abbas; Maghsoudi, Behzad; Tabatabaee, Hamidreza; Keshavarzi, Sareh; Bagheri, Zahra; Sajedianfard, Javad; Gerami, Hamid

    2015-01-01

    Background and Objectives. Cardiovascular diseases are the leading cause of death worldwide, with coronary artery disease being the most common. With increasing numbers of patients, Coronary Artery Bypass Grafting (CABG) has become the most common operation in the world. Respiratory disorder is one of the most prevalent complications of CABG. Thus, weaning off the mechanical ventilation and extubation are of great clinical importance for these patients. Some post-operative problems also relate to the tracheal tube and mechanical ventilation. Therefore, an increase in this leads to an increase in the number of complications, length of hospital stay, and treatment costs. Since a large number of factors affect the post-operative period, the present study aims to identify the predictors of extubation time in CABG patients using casualty network analysis. Method. This longitudinal study was conducted on 800 over 18 year old patients who had undergone CABG surgery in three treatment centers affiliated to Shiraz University of Medical Sciences. The patients’ information, including pre-operative, peri-operative, and post-operative variables, was retrospectively extracted from their medical records. Then, the data was comprehensively analyzed through path analysis using MPLUS-7.1 software. Results. The mean of extubation time was 10.27 + 4.39 h. Moreover, extubation time was significantly affected by packed cells during the Cardiopulmonary Bypass (CPB), packed cells after CPB, inotrope use on arrival at ICU, mean arterial pressure 1st ICU, packed cells 1st ICU, platelets 1st ICU, Blood Urea Nitrogen 1st ICU, and hematocrit 1st ICU. Conclusion. Considering all of the factors under investigation, some peri-operative and post-operative factors had significant effects. Therefore, considering the post-operative factors is important for designing a treatment plan and evaluating patients’ prognosis.

  14. Preparation of Proteoglycan Mimetic Graft Copolymers.

    Science.gov (United States)

    Kipper, Matt J; Place, Laura W

    2016-01-01

    Proteoglycans are proteins with pendant glycosaminoglycan polysaccharide side chains. The method described here enables the preparation of graft copolymers with glycosaminoglycan side chains, which mimic the structure and composition of proteoglycans. By controlling the stoichiometry, graft copolymers can be obtained with a wide range of glycosaminoglycan side-chain densities. The method presented here uses a three-step reaction mechanism to first functionalize a hyaluronic acid backbone, followed by reductive amination to couple the glycosaminoglycan side chain to the backbone, by the reducing end. Proteoglycan mimics like the ones proposed here could be used to study the structure-property relationships of proteoglycans and to introduce the biochemical and biomechanical properties of proteoglycans into biomaterials and therapeutic formulations. PMID:26537466

  15. Autologous miniature skin punch grafting in vitiligo

    Directory of Open Access Journals (Sweden)

    Singh K

    1995-01-01

    Full Text Available Forty-five sites of stable vitiligo in 32 patients refractory to medical treatment were subjected to autologous miniature skin punch grafting. Main instruments used were skin biopsy punches 1-3 mm in diameter. Donor sites selected were either gluteal region or extensor aspect of the thigh which were not affected by the disease in the past. Most of the grafts changed from brown to black and upper scales desquamated within 10-15 days. Uniform perigraft pigmentation was observed by 1-1½ months and 90% area was covered within 3-4 months. The cases were followed up for six months. Fair to excellent results were observed in 87.5% of the cases.

  16. Policies for full employment

    OpenAIRE

    Koning, Jaap de; Layard, Richard; Nickel, Stephen; Westergård-Nielsen, Niels Chr.

    2008-01-01

    European unemployment is too high, and employment is too low. Over 7½ per cent of Europe's workforce is unemployed, and only two thirds of people aged 15-64 are in work. At the Lisbon summit two years ago the heads of government set the target that by 2010 the employment rate should rise from 64 per cent to at least 70 per cent. And for older workers between 55 and 64 the employment rate should rise from 38 per cent to at least one half. These are ambitious targets. They will require two big ...

  17. Policies for full employment

    DEFF Research Database (Denmark)

    de Koning, Jaap; Layard, Richard; Nickel, Stephen; Westergård-Nielsen, Niels Chr.

    2004-01-01

    European unemployment is too high, and employment is too low. Over 7½ per cent of Europe's workforce is unemployed, and only two thirds of people aged 15-64 are in work. At the Lisbon summit two years ago the heads of government set the target that by 2010 the employment rate should rise from 64 per cent to at least 70 per cent. And for older workers between 55 and 64 the employment rate should rise from 38 per cent to at least one half. These are ambitious targets. They will require two big cha...

  18. Fungal biodegradation of lignopolystyrene graft copolymers.

    OpenAIRE

    Milstein, O; Gersonde, R.; Huttermann, A; M. J. Chen; Meister, J J

    1992-01-01

    White rot basidiomycetes were able to biodegrade styrene (1-phenylethene) graft copolymers of lignin containing different proportions of lignin and polystyrene [poly(1-phenylethylene)]. The biodegradation tests were run on lignin-styrene copolymerization products which contained 10.3, 32.2, and 50.4% (wt/wt) lignin. The polymer samples were incubated with the white rot fungi Pleurotus ostreatus, Phanerochaete chrysosporium, and Trametes versicolor and the brown rot fungus Gloeophyllum trabeum...

  19. LATE RENAL GRAFT REJECTION: PATHOLOGY AND PROGNOSIS

    Directory of Open Access Journals (Sweden)

    E.S. Stolyarevich

    2014-05-01

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

  20. Photoactivated surface grafting from PVDF surfaces

    OpenAIRE

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

    2011-01-01

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

  1. Influenza virus vaccination and kidney graft rejection

    DEFF Research Database (Denmark)

    Fischer, Anne Sophie Lind; Møller, Bjarne Kuno; Krag, Søren; Jespersen, Bente

    2015-01-01

    Influenza can cause significant morbidity and mortality in renal transplant recipients especially with a high rate of lower respiratory disease. Annual influenza vaccination is therefore recommended to renal transplant recipients. We report the first three cases of acute kidney injury in renal transplant recipients following influenza vaccination that all led to graft loss. They all had different native diseases and were all vaccinated in the same season of 2009-10. The time span from vaccinatio...

  2. Autologus parietal grafts in preprosthethic surgery

    OpenAIRE

    GHERLONE, E.F.; R. Vinci; D’AVERSA, L.

    2010-01-01

    Edentulous patients usually request implant supported/fixed rehabilitation. Ridge resorption after teeth loss usually affect three-dimensional implant position. Vertical and/or horizontal bone augmentation procedures are often the only choice the clinician has to deliver prosthetic guided restoration. Gold standard for augmentation procedures such as sinus lift, onlay or inlay grafts, is still autologous bone. The patient in this report underwent a pre-prosthetic reconstruction of the jaws wi...

  3. Mechanics of laser cut stent grafts.

    Czech Academy of Sciences Publication Activity Database

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

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

  4. Graft Polymerization of Styrene to Polyethylene

    International Nuclear Information System (INIS)

    Study of published data on radiationinduced grafting of styrene to low density polyethylene films shows that the rate of weight gain has only a small dependence upon the gamma exposure rate and film thickness. It is demonstrated that the models used by previous investigators to interpret weight- gain data for evaluation of rate constants are not applicable. Data are presented for grafting experiments at 18 and 40oC using polyethylene films and fluff and Co60 gamma exposure rates up to 8.0 x 105 r/hr. The rate of conversion of styrene to homopolymer in the fluff suspensions was also measured. Microscopic examinations were performed on the grafted film to estimate the amount of occluded homopolymer. The results demonstrate that most of the weight gain in film samples is due to occluded homopolymer. In the fluff experiments, in which the weight gain is largely due to graft copolymer, the weight increase is approximately linear with dose and the reaction rate is almost proportional to the square root of the gamma exposure rate. A low activation energy for the reaction rate precludes the possibility of diffusion control in fluff and in thin films at exposure rates below 105 r/hr. The rate of homopolymer formation in the fluff experiments performed at 18oC and 7.2 x 104 r/hr is the same as that reported for polymer formation in pure styrene. The activation energy, 3.5 kcal/mol, is almost half the value reported for the pure monomer. (author)

  5. Outcomes of coronary artery bypass graft surgery

    OpenAIRE

    Hawkes, Anna Louise; Nowak, Madeleine; Bidstrup, Benjamin; Speare, Richard

    2006-01-01

    This review article summarizes the major studies that have investigated the outcomes of coronary artery bypass graft surgery (CABG). The article includes a review of the literature in the areas of: history of CABG; indications for CABG; and measurement of quality of life following CABG, including prolongation of life, physical functioning (ie, relief from angina and dyspnea, physical activity, as well as complications of surgery and re-hospitalization), psychological functioning, and social f...

  6. Graft selection in anterior cruciate ligament reconstruction.

    Science.gov (United States)

    Miller, Suzanne L; Gladstone, James N

    2002-10-01

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

  7. Graft copolymerized chitosan : present status and applications

    OpenAIRE

    Jayakumar, R.; Prabaharan, M.; R. L. Reis; J.F. Mano

    2005-01-01

    Chitosan is a natural based polymer obtained by alkaline deacetylation of chitin, exhibiting excellent biological properties such as biodegradation in the human body, and immunological, antibacterial, and wound-healing activity. Chitosan has also been found to be a good candidate as a support material for gene delivery, cell culture and tissue engineering. However, practical use of chitosan has been mainly confined to the unmodified forms. For a breakthrough in utilization, graft cop...

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

    Scientific Electronic Library Online (English)

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

    2014-12-01

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

  9. Allogenic lyophilized cartilage grafts for craniomaxillofacial reconstruction

    International Nuclear Information System (INIS)

    Allogenic lyophilized cartilages were made in our clinic after Sailer methods and some modification. In our clinic, we have used allogenic cartilage grafts on 102 defects of craniomaxillofacial area; 1) for defects from cyst or ameloblastoma, 2) for lack of continuity of the mandible, 3) for rhinoplasty, 4) for paranasal augmentation, 5) for augmentation genioplasty, 6) for reconstruction of orbital floor, 7) for oroantral fistula, 8) for temporal augmentation, 9) for TMJ surgery 10) for condyle defect as a costochondral graft, 11) for filling of tooth socket and alveolus augmentation,12) for correction or orbital height and 13) for guided bone regeneration in peripheral implant. The types of lyophilized cartilage used were chip, sheet and block types developed by freeze-dried methods. Some grafts showed change of ossification, in which case we could perform implant on it. We have good results on reconstruction of craniomaxillofacial defects. Allogenic cartilage have advantages such as 1) it has no immune reaction clinically, 2) it is more tolerable to infection than that of autogenous cartilage, 3) it has character of less resorption which require no over correction, 4) it is easy to manipulate contouring, and 5) it has possibility of undergoing ossification. Allogenic cartilage has been considered as good substitutes for bone. The author would like to report the results on 102 allogenic cartilage have

  10. A Patient with Recurrent Arteriovenous Graft Thrombosis.

    Science.gov (United States)

    Allon, Michael

    2015-12-01

    Arteriovenous grafts (AVGs) are prone to frequent thrombosis that is superimposed on underlying hemodynamically significant stenosis, most commonly at the graft-vein anastomosis. There has been great interest in detecting AVG stenosis in a timely fashion and performing preemptive angioplasty, in the belief that this will prevent AVG thrombosis. Three surveillance methods (static dialysis venous pressure, flow monitoring, and duplex ultrasound) can detect AVG stenosis. Whereas observational studies have reported that surveillance with preemptive angioplasty substantially reduces AVG thrombosis, randomized clinical trials have failed to confirm such a benefit. There is a high frequency of early AVG restenosis after angioplasty caused by aggressive neointimal hyperplasia resulting from vascular injury. Stent grafts prevent AVG restenosis better than balloon angioplasty, but they do not prevent AVG thrombosis. Several pharmacologic interventions to prevent AVG failure have been evaluated in randomized clinical trials. Anticoagulation or aspirin plus clopidogrel do not prevent AVG thrombosis, but increase hemorrhagic events. Treatment of hyperhomocysteinemia does not prevent AVG thrombosis. Dipyridamole plus aspirin modestly decreases AVG stenosis or thrombosis. Fish oil substantially decreases the frequency of AVG stenosis and thrombosis. In patients who have exhausted all options for vascular access in the upper extremities, thigh AVGs are a superior option to tunneled internal jugular vein central vein catheters (CVCs). An immediate-use AVG is a reasonable option in patients with recurrent CVC dysfunction or infection. Tunneled femoral CVCs have much worse survival than internal jugular CVCs. PMID:25883073

  11. Dorsal Versus Ventral Oral Mucosal Graft Urethroplasty

    Directory of Open Access Journals (Sweden)

    Jalil Hosseini

    2011-03-01

    Full Text Available PURPOSE: To evaluate success rate of dorsal versus ventral oral mucosal graft for anterior urethroplasty.MATERIALS AND METHODS: In a retrospective study, the results of the ventral and dorsal oral mucosal graft (OMG anterior urethroplasty were assessed in 24 and 29 patients, respectively. Demographic and clinical characteristics of subjects were gathered from the medical records.RESULTS: Patients were followed up for a mean duration of 32 months (range, 25 to 51 months. The success rates of dorsal and ventral anterior OMG urethroplasty were 83.3% and 75.8%, respectively (P = .5. At penile site, dorsal and ventral OMG were done for 9 and 10 patients with stricture lengths of 3.7 ± 1.1 cm and 3.9 ± 1.2 cm, respectively (P = .7. Success rates of dorsal and ventral penile OMG were 88.9% and 70%, respectively (P = .3. At the bulbar site, dorsal and ventral OMG were performed on 15 and 19 patients with stricture lengths of 4.1 ± 1.1cm and 4.2 ± 1.5 cm, respectively (P = .7. The success rates of dorsal and ventral bulbar OMG were 80% and 79%, respectively (P = .94.CONCLUSION: Oral mucosal graft is a versatile and an effective procedure for management of strictures throughout the anterior urethra, and in experienced hands, the outcomes are similarly favorable whether a dorsal or ventral approach is taken.

  12. Effects of intraoperative external head cooling on short-term cognitive function in patients after coronary artery bypass graft surgery.

    Science.gov (United States)

    Sirvinskas, E; Usas, E; Mankute, A; Raliene, L; Jakuska, P; Lenkutis, T; Benetis, R

    2014-03-01

    The aim of study was to assess the effects of an intraoperative external head-cooling technique on cognitive dysfunction in the early postoperative period (at the 10th day) in patients after coronary artery bypass graft (CABG) surgery. Patients in Group H (n=25) were cooled with CPB and the intraoperative, external head-cooling technique, patients in Group C (n=25) were cooled only with cardiopulmonary bypass (CPB) to achieve mild hypothermia (33 - 34 °C). Cognitive function was analyzed before the operation and after the surgery using the Mini Mental State Examination (MMSE), the Modified Visual Reproduction Test from the Wechsler Memory Scale, Trail Making (A/B), WAIS--Digit Span (WDS) and WAIS Digit Symbol Substitution Test (WDSST). The incidence of cognitive impairment at the 10th day after the surgery was 36% (n=9) in Group H and 64% (n=16) in Group C (p=0.048). The temperature during the aortic cross-clamp period was associated with a lower rate of cognitive dysfunction (p=0.05, r(2)=0.09). The intraoperative, external head-cooling technique during the aortic cross-clamp period has a neuroprotective effect and leads to less short-term cognitive function impairment after CABG surgery. PMID:23878011

  13. Youth Employment and Unemployment

    Science.gov (United States)

    OECD Observer, 1977

    1977-01-01

    Discusses youth employment and unemployment in Canada, France, Germany, Italy, Japan, United Kingdom, and the United States; the trends, causes, consequences, policy goals, and specific measures needed to resolve problems. (SL)

  14. Globalisation, growth and employment

    OpenAIRE

    Michie , Jonathan; Oughton, Christine; Zanfei, Antonello

    2002-01-01

    The full-text of this article is not available in ORA at this time. Citation: Michie, J., Oughton, C. & Zanfei, A. (2002). 'Globalisation, growth and employment', Journal of Interdisciplinary Economics, 13(1-3), 1-12.

  15. Asymmetric information between employers

    OpenAIRE

    Kahn, Lisa B.

    2013-01-01

    Employer learning about workers' abilities plays a key role in determining how workers sort into jobs and are compensated. This study explores whether learning is symmetric or asymmetric, i.e., whether potential employers have the same information about worker ability as the incumbent firm. I develop a model of asymmetric learning that nests the symmetric learning case and allows the degree of asymmetry to vary, yielding testable implications for the prevalence of asymmetric learning. I then ...

  16. Development aid and employment

    OpenAIRE

    Hoeven, R.E. van der

    2012-01-01

    Abstract. Globalization has led to a precarization of labour, which especially manifests in the unstable working conditions, a lower labour share in national income as well as in a growing income inequality, with the exception of some countries with high initial income inequality. The neglect of concern for employment and inequality in the formulation of the Millennium Development Goals (MDGs) in 2000 is noted; the addition of a goal for full employment in a reformulation of th...

  17. Estudo da função pulmonar em pacientes submetidos a revascularização do miocárdio sem circulação extracorpórea com derivação intraluminal / Pulmonary function study in patients who underwent myocardial revascularization without cardiopulmonary bypass with an intraluminal shunt

    Scientific Electronic Library Online (English)

    Ana Maria Rocha, Pinto; Roberto, Stirbulov; Luiz Antonio, Rivetti; Roberto, Saad Júnior.

    1998-12-01

    Full Text Available As alterações da função pulmonar nos pacientes submetidos a cirurgias com auxílio da Circulação Extracorpórea (CEC) têm sido relatadas na literatura. O objetivo do presente estudo foi analisar a função pulmonar de um grupo de pacientes submetidos a cirurgia de revascularização do miocárdio sem o uso [...] da CEC. Foram estudados de maneira prospectiva 23 pacientes portadores de insuficiência coronariana e submetidos a cirurgia de revascularização do miocárdio sem CEC. A idade variou de 36 a 69 anos, sendo 16 pacientes do sexo masculino e sete do sexo feminino. A avaliação da função pulmonar foi feita através de espirometria e prova alvéolo-respiratória, realizadas no período pré-operatório, no quarto dia (PO4) e no décimo dia (PO10> pós-operatório. A análise dos dados revelou redução da Capacidade Vital (CV) em 37,84% (p Abstract in english Pulmonary complications are a major cause of postoperative morbidity and mortality in those patients undergoing operations utilizing cardiopulmonary bypass. The purpose of this study was to evaluate the pulmonary function after myocardial revascularization without cardiopulmonary bypass using a intr [...] aluminal shunt. Twenty-three patients with coronary disease were submitted to surgery by this technique and pulmonary function testing was conducted consecutively. The surgeries were performed via a median sternotomy with a reversed saphenous vein and/or an internal mammary artery graft. The age ranged from 36 to 69 years (mean 56,3 years). The group was comprised by 16 men and seven women. The pulmonary function tests consisted of spirometric investigations and blood gases measurements with evaluation of intrapulmonary shunt degree, both analyzed during the preoperative period, at the 4th (PO4) and at the 10th (PO10) postoperative day. In spirometry were determinated the vital capacity (VC), forced vital capacity (FVC), forced expiratory volume at one second (FEV), forced expiratory flow over middle half of FVC (FEF 25-75), coefficient of the one second expiratory volume (FEV/FVC), coefficient of middle expiratory flow (FEF 25-75/FVC) and maximal voluntary ventilation (MVV). The VC showed at the PO4 a mean decrease of 37.80% (p

  18. Deficiency of employability capacity

    Directory of Open Access Journals (Sweden)

    Pelse I.

    2012-10-01

    Full Text Available Young unemployed people have comprised one of the significantly largest groups of the unemployed people in Latvia in recent years. One of the reasons why young people have difficulty integrating into the labour market is the “expectation gap” that exists in the relations between employers and the new generation of workers. Employers focus on capacity-building for employability such individual factors as strength, patience, self-discipline, self-reliance, self-motivation, etc., which having a nature of habit and are developed in a long-term work socialization process, which begins even before the formal education and will continue throughout the life cycle. However, when the socialization is lost, these habits are depreciated faster than they can be restored. Currently a new generation is entering the labour market, which is missing the succession of work socialization. Factors, such as rising unemployment and poverty in the background over the past twenty years in Latvia have created a very unfavourable employability background of “personal circumstances” and “external factors”, which seriously have impaired formation of the skills and attitudes in a real work environment. The study reveals another paradox – the paradox of poverty. Common sense would want to argue that poverty can be overcome by the job. However, the real state of affairs shows that unfavourable coincidence of the individual, personal circumstances and external factors leads to deficit of employability capacity and possibility of marked social and employment deprivation.

  19. Radiation grafting of various water-soluble monomers on ultra-high molecular weight polyethylene powder: Part I. Grafting conditions and grafting yield

    International Nuclear Information System (INIS)

    Monomers of some water-soluble polymers; acrylic acid, methacrylic acid, acrylamide, N, N-dimethyl acrylamide and 1-vinyl-2 pyrrolidone, were grafted on ultra-high molecular weight polyethylene (UHMWPE) powders by a direct grafting method in an aqueous medium in air. Inhibition of homopolymerisation was achieved by adding various concentrations of Fe2+ or Cu2+ ions. It was found that the degree of grafting increases linearly with dose till a gelation state is reached, and varies between 40 and 12% depending on the monomer. Four million molecular weight UHMWPE gave a higher per cent grafting than a 6 million counterpart for the monomers used, with the exception of acrylic acid monomer grafting. (author)

  20. Fluorescence spectroscopy for assessment of liver transplantation grafts concerning graft viability and patient survival

    Science.gov (United States)

    Vollet Filho, José D.; da Silveira, Marina R.; Castro-e-Silva, Orlando; Bagnato, Vanderlei S.; Kurachi, Cristina

    2015-06-01

    Evaluating transplantation grafts at harvest is essential for its success. Laser-induced fluorescence spectroscopy (LIFS) can help monitoring changes in metabolic/structural conditions of tissue during transplantation. The aim of the present study is to correlate LIFSobtained spectra of human hepatic grafts during liver transplantation with post-operative patients' mortality rate and biochemical parameters, establishing a method to exclude nonviable grafts before implantation. Orthotopic liver transplantation, piggyback technique was performed in 15 patients. LIFS was performed under 408nm excitation. Collection was performed immediately after opening donor's abdominal cavity, after cold perfusion, end of back-table period, and 5 min and 1 h after warm perfusion at recipient. Fluorescence information was compared to lactate, creatinine, bilirubin and INR levels and to survival status. LIFS was sensitive to liver changes during transplantation stages. Study-in-progress; initial results indicate correlation between fluorescence and life/death status of patients.

  1. Radiation grafting of styrene on starch with high efficiency

    Science.gov (United States)

    Sheikh, N.; Akhavan, A.; Ataeivarjovi, E.

    2013-04-01

    Wheat starch grafted with polystyrene (PS-g-starch) was synthesized via polymerization grafting of styrene on starch by gamma-ray. The effects of starch/styrene weight ratio, and amount of applied doses (5-40 kGy) on the percentage of grafting, G (%), were investigated. The results showed that G (%) increased with increasing starch content. The optimum condition, starch/styrene weight ratio 1/3 and the applied dose 10 kGy, led to 252.9% of grafting. The obtained graft copolymer was characterized by Fourier transform infrared spectroscopy, X-ray diffraction, thermal gravimetric analysis, and scanning electron microscopy. FTIR spectroscopy as well as the XRD analysis exhibited the changes in chemical and crystalline structure of starch after grafting reaction. TGA demonstrated the changes in thermal stability of PS-g-starch copolymer. SEM micrographs indicated porous patches of PS adhering on the starch.

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

    Directory of Open Access Journals (Sweden)

    Buth Karen J

    2007-10-01

    Full Text Available Abstract Background While it is believed that total arterial grafting (TAG for coronary artery bypass grafting (CABG confers improved long-term outcomes when compared to conventional grafting with left internal mammary artery and saphenous vein grafts (LIMA+SVG, to date, this has not become the standard of care. In this study, we assessed the impact of TAG on medium-term outcomes after CABG. Methods Peri-operative data was prospectively collected on consecutive first-time, isolated CABG patients between 1995 and 2005. Patients were divided into two groups based on grafting strategy: TAG (all arterial grafts no saphenous veins or LIMA+SVG. Patients who had an emergent status or underwent fewer than two distal bypasses were excluded. Medium term univariate and risk-adjusted comparisons between TAG and LIMA+SVG cases were performed. Results A total of 4696 CABG patients were included with 1019 patients undergoing TAG (22%. Unadjusted in-hospital mortality was 1.5% for TAG patients compared to 2.0% for LIMA+SVG (p = 0.31. The mean follow-up was 4.8 ± 2.0 years for TAG patients compared to 6.1 ± 3.0 years for LIMA+SVG patients (p Conclusion Patients undergoing TAG appear to experience lower rates of medium-term all-cause mortality and readmission to hospital for any cardiac cause when compared to patients undergoing LIMA+SVG. However, after adjusting for clinical variables, this difference no longer persists suggesting that at median follow-up there are no mortality or morbidity benefit based on the choice of conduit.

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

    Directory of Open Access Journals (Sweden)

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

    2009-10-01

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

  4. Striatal grafts in a rat model of Huntington's disease

    DEFF Research Database (Denmark)

    Guzman, R; Meyer, M; Lövblad, K O; Ozdoba, C; Schroth, G; Seiler, R W; Widmer, H R

    1999-01-01

    Survival and integration into the host brain of grafted tissue are crucial factors in neurotransplantation approaches. The present study explored the feasibility of using a clinical MR scanner to study striatal graft development in a rat model of Huntington's disease. Rat fetal lateral ganglionic eminences grown as free-floating roller-tube cultures were grafted into the quinolinic acid-lesioned striatum, and T1- and T2-weighted sequences were acquired at 2, 7, 21, and 99 days posttransplantatio...

  5. Facile grafting of bioactive cellulose derivatives onto PVC surfaces

    Science.gov (United States)

    Bigot, Sandra; Louarn, Guy; Kébir, Nasreddine; Burel, Fabrice

    2013-10-01

    Bioactive methyl cellulose and hydroxyethyl cellulose were successfully grafted onto PVC films using a two-step pathway. PVC surface was first modified with isothiocyanate in DMSO/water medium. Then, unmodified polysaccharides were directly grafted onto the thiocyanated surface in acetonitrile/DMSO mixture, in presence of DBTL as catalyst. The polysaccharide grafting onto the PVC surface was evidenced by contact angle measurements, AFM and XPS.

  6. Radiation sterilization in the practice of grafts and tissue banks

    International Nuclear Information System (INIS)

    The world and Polish experience in radiation sterilization of tissues and grafts and their banking has been presented. The techniques of biostatic grafts sterilization and banking in low temperatures as well as the methods of dose control have been shown. The ESR technique use for study of radiation induced paramagnetic centres in mineralized tissues as well as the fate of grafts after transplantation have been also discussed. 33 refs

  7. Target-like Pigmentation After Minipunch Grafting in Stable Vitiligo

    OpenAIRE

    Bisen, Nelee; Bhat, Ramesh M.; Lahiri, Koushik; Kambil, Srinath M

    2014-01-01

    Surgical treatment for vitiligo has been ever evolving. Each surgical modality has its own benefits and limitations. Miniature punch grafting is the most extensively performed surgery, which gives good results in stable vitiligo. Herein we report an unusual type of repigmentation observed after minipunch grafting in a patient of stable vitiligo, which resembled target-like lesions with a “perigraft halo” surrounding individual grafts. Such pigment spread occurred despite the use of 0.5 mm lar...

  8. Post-radiation grafting of styrene to polyethylene film and distribution of grafted polystyrene in it

    International Nuclear Information System (INIS)

    The post-radiation grafting of styrene to polyethylene (PE) film irradiated in air with 60Co source (dose rate 520 R/s) and electron accelerator (dose rate 1.5x105 R/s) has been studied, in the range 1-100 Mrad. The influence of additives of ferrous salts on kinetics of this process is shown. The distribution of grafted polystyrene in PE for various power and dose of irradiation has been analysed basing on IR spectra. The essential role of diffusion of iron ions into the film volume on kinetics of the process and polystyrene distribution is concluded

  9. Employability Skills Indicator as Perceived by Manufacturing Employers

    OpenAIRE

    Mohamad Sattar Rasul; Azlin Norhaini Mansor

    2013-01-01

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

  10. Acute and Subacute Effects of Urban Air Pollution on Cardiopulmonary Emergencies and Mortality: Time Series Studies in Austrian Cities

    OpenAIRE

    Daniel Rabczenko; Hanns Moshammer; Manfred Neuberger

    2013-01-01

    Daily pollution data (collected in Graz over 16 years and in the Linz over 18 years) were used for time series studies (GAM and case-crossover) on the relationship with daily mortality (overall and specific causes of death). Diagnoses of patients who had been transported to hospitals in Linz were also available on a daily basis from eight years for time series analyses of cardiopulmonary emergencies. Increases in air pollutant levels over several days were followed by increases in mortality a...

  11. Acute exposure to elevated PM2.5 generated by traffic and cardiopulmonary health effects in healthy older adults

    OpenAIRE

    FAN, ZHIHUA (TINA); Meng, Qingyu; WEISEL, CLIFFORD; LAUMBACH, ROBERT; Ohman-Strickland, Pamela; Shalat, Stuart; HERNANDEZ, MARTA Z.; Black, Kathleen

    2008-01-01

    There are evidences for exposure to vehicular emissions and adverse cardiopulmonary health effects. This study attempted to further explore these effects on elderly. This study monitored personal PM2.5 concentrations and ambulatory electrocardiograms continuously for 24 h on 1 working day in 3 separate weeks for 11 school crossing guards. Spirometry was also performed before and after the morning shift. The traffic at each work location was video recorded during one of the three morning shift...

  12. Coronary Flow Reserve Predicts Cardiopulmonary Fitness in Patients with Coronary Artery Disease Independently of Systolic and Diastolic Function

    DEFF Research Database (Denmark)

    Snoer, Martin; Olsen, Rasmus Huan

    2014-01-01

    Despite revascularization and optimal medical treatment, patients with coronary artery disease (CAD) have reduced exercise capacity. In the absence of coronary artery stenosis, coronary flow reserve (CFR) is a measure of coronary microvascular function, and a marker of future poor outcome in CAD patients. The aim of this study was to examine the relationship among CFR, systolic and diastolic function, peripheral vascular function, and cardiopulmonary fitness in CAD patients.

  13. Cardiopulmonary function of Young bronchitics (mostly mineworkers) before and after respiratory physiotherapy and physical training. Comparison with a control group

    Energy Technology Data Exchange (ETDEWEB)

    Marcq, M.; Minette, A.

    1981-01-01

    This article covers the effects of 4 weeks' treatment consisting of respiratory physiotherapy associated with physical training on cardiopulmonary function. It involved 12 patients (updated group) suffering from chronic bronchitis, still at an early stage in clinical terms. All patients showed signs of early broncho-destructive problems. This research was carried out with financial aid from the EEC (Agreement No. 7246-30-2-001). (32 refs.)

  14. A study assessing the impact of different teaching modalities for pharmacy students in a Cardio-Pulmonary Resuscitation (CPR) course

    OpenAIRE

    Khan, Tahir Mehmood; Hassali, Mohamed Azmi; Rasool, Sahibzada Tasleem

    2013-01-01

    The current study aims to assess the effectiveness of different teaching methods adopted for the practical session of Cardio-Pulmonary Resuscitation (CPR). CPR training is one of the compulsory modules of the Public Health Pharmacy (PHP) course at Universiti Sains Malaysia. CPR training comprises of 10% of total marks of the PHP course. To test the effectiveness of the different teaching strategies, three groups were defined using a two-stage cohort distribution—i.e. based on grade point aver...

  15. The Stop-Only-While-Shocking algorithm reduces hands-off time by 17% during cardiopulmonary resuscitation - a simulation study

    DEFF Research Database (Denmark)

    Koch Hansen, Lars; Mohammed, Anna; Pedersen, Magnus; Folkestad, Lars; Brodersen, Jacob; Hey, Thomas; Lyhne Christensen, Nicolaj; Carter-Storch, Rasmus; Bendix, Kristoffer; Hansen, Morten R; Brabrand, Mikkel; brodersen, jacob

    2015-01-01

    INTRODUCTION: Reducing hands-off time during cardiopulmonary resuscitation (CPR) is believed to increase survival after cardiac arrests because of the sustaining of organ perfusion. The aim of our study was to investigate whether charging the defibrillator before rhythm analyses and shock delivery significantly reduced hands-off time compared with the European Resuscitation Council (ERC) 2010 CPR guideline algorithm in full-scale cardiac arrest scenarios. METHODS: The study was designed as a ful...

  16. Infections with cardiopulmonary and intestinal helminths and sarcoptic mange in red foxes from two different localities in Denmark

    DEFF Research Database (Denmark)

    Al-Sabi, Mohammad Nafi Solaiman; Hisham Beshara Halasa, Tariq; Kapel, Christian M. O.

    2014-01-01

    Monitoring parasitic infections in the red fox is essential for obtaining baseline knowledge on the spread of diseases of veterinary and medical importance. In this study, screening for cardiopulmonary and intestinal helminths and sarcoptic mange (Sarcoptes scabiei) was done on 118 foxes originating from two distinct localities in Denmark, (Copenhagen) greater area and southern Jutland. Fifteen parasite species were recorded in 116 foxes (98.3%), nine parasitic species are of zoonotic potential....

  17. Cardiopulmonary resuscitation; use, training and self-confidence in skills :a self-report study among hospital personnel

    OpenAIRE

    Hopstock Laila A

    2008-01-01

    Abstract Background Immediate start of basic cardiopulmonary resuscitation (CPR) and early defibrillation have been highlighted as crucial for survival from cardiac arrest, but despite new knowledge, new technology and massive personnel training the survival rates from in-hospital cardiac arrest are still low. National guidelines recommend regular intervals of CPR training to make all hospital personnel able to perform basic CPR till advanced care is available. This study investigates CPR tra...

  18. Sheep (Ovis aries) as a Model for Cardiovascular Surgery and Management before, during, and after Cardiopulmonary Bypass

    OpenAIRE

    DiVincenti, Louis; Westcott, Robin; Lee, Candice

    2014-01-01

    Because of its similarity to humans in important respects, sheep (Ovis aries) are a common animal model for translational research in cardiovascular surgery. However, some unique aspects of sheep anatomy and physiology present challenges to its use in these complicated experiments. In this review, we discuss relevant anatomy and physiology of sheep and discuss management before, during, and after procedures requiring cardiopulmonary bypass to provide a concise source of information for veteri...

  19. Successful prolonged cardiopulmonary resuscitation after a combined intoxication with a tricyclic antidepressant, a benzodiazepine and a neuroleptic.

    Science.gov (United States)

    Christiaens, F; Lessire, H; Dellers, I; Denis, B; Vankeerberghen, L; Verborgh, C

    2000-09-01

    We report the case of a patient who co-ingested a tricyclic antidepressant (amitriptyline), benzodiazepines (alprazolam and lormetazepam) and a neuroleptic drug (prothipendyl). Major neurologic and cardiac symptoms occurred including a prolonged cardiac arrest. The cardiopulmonary resuscitation phase was complicated by a haematoma of the liver treated by a left hepatectomy. The clinical features and management of this combined intoxication are discussed. PMID:11142276

  20. Clinical, cardiopulmonary and haemocytological effects of xylazine in goats after acute exposure to different environmental temperature and humidity conditions

    OpenAIRE

    E.G.M. Mogoa; G.F. Stegmann; A. J. Guthrie; Swan, G E

    2012-01-01

    This study was carried out to assess the influence of xylazine administration on clinical, cardiopulmonary and haemocytological variables after acute exposure to different environmental conditions. Xylazine hydrochloride was administered intravenously at 0.1 mg/kg body mass to 6 clinically healthy, castrated male goats. All animals were exposed for 60 min to 3 sets of climatic conditions: 14 °C, 33% relative humidity; 24 °C, 55% RH, and 34 °C, 65% RH. The variables that were measured for a pe...

  1. Heart rate dynamics during a treadmill cardiopulmonary exercise test in optimized beta-blocked heart failure patients

    OpenAIRE

    Vitor Oliveira Carvalho; Guilherme Veiga Guimarães; Emmanuel Gomes Ciolac; Edimar Alcides Bocchi

    2008-01-01

    BACKGROUND: Calculating the maximum heart rate for age is one method to characterize the maximum effort of an individual. Although this method is commonly used, little is known about heart rate dynamics in optimized beta-blocked heart failure patients. AIM: The aim of this study was to evaluate heart rate dynamics (basal, peak and % heart rate increase) in optimized beta-blocked heart failure patients compared to sedentary, normal individuals (controls) during a treadmill cardiopulmonary exer...

  2. Employers' Gas Association (ZPZ)

    International Nuclear Information System (INIS)

    Employers' Gas Association (ZPZ) is the institution which main task is to maintain the optimum conditions for dynamic development of its members' activities, their business activities and to maintain the common or individual interests o fits members. To meet this objective, the association: - maintains the interests of association members during discussions with representative authorities, central state administration bodies and the trade unions regarding the economic and social policy and the questions which are to be the subject matter of collective bargaining, conclusion of contracts and the collective agreements of higher force; - is the member of enterprising, negotiating and advisory authorities; - coordinates the procedure and promotes the common interests of its members in relation to the representative authorities and the central state administration bodies, central trade union authorities and in relation to the international organisation of employers and the International Labour Organisation; maintains the commercial and business activities of the members of association; submits the proposals, filling with the courts and makes interventions regarding the preparation of economic and political decisions on the national and international level; engages with the legal entities in the Slovak Republic and enters the foreign international organisations. ZPZ, originally Gas Association (PZ), was founded by the General Assembly on 27th January 1995. It was registered in compliance with the Act No. 83/1990 Coll. on Association of Citizens as amended by the act No. 300/90 Coll., as the organisation of employers with the legal personality. The Employer's Gas Association was a member of the Employers' Associations in Slovak Republic till 31st March 2004, after this date it is represented by the Republican Union of Employers in SR (RUZ SR), which was established to maintain employer's associations interests on more qualitative level. The list of members, representatives of members and officials as well as their activities are presented

  3. Interfacial properties of chitosan-PEO graft oligomers

    DEFF Research Database (Denmark)

    Dedinaite, Andra; Gorochovceva, Natalija; Makuska, Ricardas; Claesson, Per M.; Iruthayaraj, Joseph

    2006-01-01

    Oligomers of chitosan carrying 45 units long poly(ethylene oxide), PEO, chains grafted to the C-6 position of the sugar units were prepared using a novel synthesis route. The graft density was high, close to one poly(ethylene oxide) chain grafted to each sugar unit of the chitosan oligomer but a small fraction of unreacted chitosan remained in the sample. The molecular weight distribution of the sample was determined using GPC. The interfacial properties of the chitosan-PEO graft oligomers were ...

  4. Modification of the water absorbance of cellulose by radiation grafting

    International Nuclear Information System (INIS)

    Complete text of publication follows. The use of natural cellulose fibres as reinforcing elements in macromolecular composite materials has recently gained considerable attention, as emphasized by the numerous articles on the topic. However, the preparation of cellulose-based composites is perturbed by the highly hydrophilic character of the fibres, which is associated with a low interfacial compatibility with hydrophobic polymeric matrices, as well as with a loss of mechanical properties after moisture uptake. In order to reduce the hydrophilic character of cellulose fibres and to improve the strength of their adhesion to the matrix, it is necessary to undertake a structural modification of their surface. Irradiation induced grafting of hydrophobic polymer chains onto the surface of cellulose fibres is a convenient technique for this purpose. In this work 2-ethylhexyl acrylate and 2-ethylhexyl methacrylate monomers were grafted onto cotton cellulose. The grafting yield was measured by the percent increase in the mass of the samples and also by FTIR spectroscopy. Optimum grafting conditions were determined by varying the monomer concentration, grafting time, irradiation temperature, and dose. The grafting was performed using both the preirradiation and mutual grafting methods. SEM pictures clearly showed the formation of a coating layer on the fibres. The swelling in water decreased with increasing grafting yield indicating the reduction of the hydrophilic character of the samples. Polymer compatibility of the grafted samples was checked by preparing polymer composite samples.

  5. Eyebrow Reconstruction Using a Composite Skin Graft from Sideburns

    Directory of Open Access Journals (Sweden)

    Ken Matsuda, MD, PhD

    2015-01-01

    Full Text Available Summary: Wide resection of malignant skin tumors in the upper orbital region often results in soft-tissue defects involving the eyebrow. We used composite skin grafts from the area around the sideburns for 1-stage reconstruction of skin and eyebrow defects. The results were aesthetically satisfying because the hair and shape of these regions were similar to those of the original eyebrow, and donor-site closure was easy with inconspicuous scar. The survival of full-thickness skin graft area of composite grafts from sideburn facilitates revascularization of thicker hair follicles in the graft and allows safe, natural eyebrow reconstruction.

  6. Crystallization of calcium carbonate on radiation-grafted polyethylene films

    International Nuclear Information System (INIS)

    In biomineralization processes, nucleation and growth of inorganic crystals can be regulated by organic template molecules. This has inspired great interest in studying mimic biomineralization. In our study, growing CaCO3 crystals on PE films functionalized through radiation-induced grafting was attempted. PE films grafted with different functional groups of different distributions and densities were used as substrates for CaCO3 nucleation and crystal growth from Ca(HCO3)2 supersaturated solution under different environmental conditions (e.g. additives and temperature) to study the effects and mechanisms. The grafted PE films were analyzed by ATR-FTIR and AFM, and the evolution of CaCO3 crystal formation on the grafted PE film was characterized by SEM, FTIR, and XRD. The results indicated that heterogeneous nucleation of CaCO3 crystals was significantly facilitated by the functional groups grafted on the surface of PE films, that the morphology of CaCO3 crystals could be controlled by distribution and density of the grafted functional groups, and that polymorphism of CaCO3 crystal could be regulated by selection of grafting functional groups. We believe that studying the effects of chemical structures on inorganic crystallization is of great importance since radiation-induced grafting is an effective method to graft desirable functional groups onto different polymers by selected monomers, in the endeavor of developing advanced organic/inorganic composites with high performance, with a wide availability of polymers, monomers and inorganic solutions. (authors)

  7. The Radiation Induced Graft Copolymerization of Methacrylic Acid to Nylon

    International Nuclear Information System (INIS)

    The grafting of methacrylic acid to nylon by the preirradiation technique has been studied. The rate of grafting is appreciably larger than that of homopolymerization. No simple relation exists between reaction rate and total dose. The temperature dependence of the rate of grafting to the fibre, preirradiated in air, indicates that initiation of grafting is likely to take place by decomposition of peroxide groups formed on irradiation. Electrical resistance measurements on the irradiated fibre indicate that this has been reduced by a factor of 10. (author)

  8. Sulfonated hydrocarbon graft architectures for cation exchange membranes

    DEFF Research Database (Denmark)

    Nielsen, Mads MØller; Jankova Atanasova, Katja

    2013-01-01

    A synthetic strategy to hydrocarbon graft architectures prepared from a commercial polysulfone and aimed as ion exchange membrane material is proposed. Polystyrene is grafted from a polysulfone macroinitiator by atom transfer radical polymerization, and subsequently sulfonated with acetyl sulfate to various degrees. Series of grafting densities and graft lengths are prepared, and membranes are solvent cast from DMSO. The membrane properties in aqueous environments are evaluated from their water swelling behavior, and their thermal properties and stability are investigated by thermogravimetric analysis and differential scanning calorimetry.

  9. A Novel Porcine Graft for Regeneration of Bone Defects

    Directory of Open Access Journals (Sweden)

    Eisner Salamanca

    2015-05-01

    Full Text Available Bone regeneration procedures require alternative graft biomaterials to those for autogenous bone. Therefore, we developed a novel porcine graft using particle sizes of 250–500 ?m and 500–1000 ?m in rabbit calvarial bone defects and compared the graft properties with those of commercial hydroxyapatite (HA/beta-tricalcium phosphate (?-TCP over eight weeks. Surgery was performed in 20 adult male New Zealand white rabbits. During a standardized surgical procedure, four calvarial critical-size defects of 5 mm diameter and 3 mm depth were prepared. The defects were filled with HA/?-TCP, 250–500 ?m or 500–1000 ?m porcine graft, and control defects were not filled. The animals were grouped for sacrifice at 1, 2, 4, and 8 weeks post-surgery. Subsequently, sample blocks were prepared for micro-computed tomography (micro-CT scanning and histological sectioning. Similar bone formations were observed in all three treatment groups, although the 250–500 ?m porcine graft performed slightly better. Rabbit calvarial bone tissue positively responded to porcine grafts and commercial HA/?-TCP, structural analyses showed similar crystallinity and porosity of the porcine and HA/?-TCP grafts, which facilitated bone formation through osteoconduction. These porcine grafts can be considered as graft substitutes, although further development is required for clinical applications.

  10. Implantation of Vascular Grafts Lined with Genetically Modified Endothelial Cells

    Science.gov (United States)

    Wilson, James M.; Birinyi, Louis K.; Salomon, Robert N.; Libby, Peter; Callow, Allan D.; Mulligan, Richard C.

    1989-06-01

    The possibility of using the vascular endothelial cell as a target for gene replacement therapy was explored. Recombinant retroviruses were used to transduce the lacZ gene into endothelial cells harvested from mongrel dogs. Prosthetic vascular grafts seeded with the genetically modified cells were implanted as carotid interposition grafts into the dogs from which the original cells were harvested. Analysis of the graft 5 weeks after implantation revealed genetically modified endothelial cells lining the luminal surface of the graft. This technology could be used in the treatment of atherosclerosis disease and the design of new drug delivery systems.

  11. Target-like pigmentation after minipunch grafting in stable vitiligo

    Directory of Open Access Journals (Sweden)

    Nelee Bisen

    2014-01-01

    Full Text Available Surgical treatment for vitiligo has been ever evolving. Each surgical modality has its own benefits and limitations. Miniature punch grafting is the most extensively performed surgery, which gives good results in stable vitiligo. Herein we report an unusual type of repigmentation observed after minipunch grafting in a patient of stable vitiligo, which resembled target-like lesions with a "perigraft halo" surrounding individual grafts. Such pigment spread occurred despite the use of 0.5 mm larger graft from the donor site.

  12. MRI of double-bundle ACL reconstruction: evaluation of graft findings

    International Nuclear Information System (INIS)

    To demonstrate the magnetic resonance imaging (MRI) findings of double-bundle (DB) anterior cruciate ligament (ACL) reconstruction grafts. Sixty-six patients with DB ACL reconstruction were evaluated with MRI 2 years postoperatively. Graft thickness was measured separately by two musculoskeletal radiologists. The MRI findings of graft disruption, signal intensity (SI) changes, cystic degeneration, arthrofibrosis, and impingement were analyzed. The statistical significance of the association between MRI findings was calculated. The mean anteromedial (AM) graft thickness was reduced 9% and the mean posterolateral (PL) graft thickness was reduced 18% from the original graft thickness. Disruption was seen in 3% of AM grafts and 6% of PL grafts and a partial tear in 8 and 23%, respectively. Both grafts were disrupted in 3% of patients. Increased SI was seen in 14% of intact AM grafts and in 60% of partially torn AM grafts (p = 0.032). In PL grafts the increased SI was seen in 51% of the intact grafts and in 93% of the partially torn grafts (p = 0.005). Cystic degeneration was seen in 8% of AM grafts and in 5% of PL grafts. Diffuse arthrofibrosis was seen in 5% of patients and a localized cyclops lesion in 3% of patients. Impingement of the AM graft was seen in 8% of patients. Both grafts were disrupted in 3% of patients. Also, the frequencies of other complications were low. The use of orthogonal sequences in the evaluation of the PL graft SI seems to cause volume-averaging artefacts. (orig.)

  13. MRI of double-bundle ACL reconstruction: evaluation of graft findings

    Energy Technology Data Exchange (ETDEWEB)

    Kiekara, Tommi; Paakkala, Antti [Tampere University Hospital, Medical Imaging Centre, Tampere (Finland); Jaervelae, Timo [Sports Clinic and Hospital Mehilaeinen, Tampere (Finland); Huhtala, Heini [University of Tampere, School of Health Sciences, Tampere (Finland)

    2012-07-15

    To demonstrate the magnetic resonance imaging (MRI) findings of double-bundle (DB) anterior cruciate ligament (ACL) reconstruction grafts. Sixty-six patients with DB ACL reconstruction were evaluated with MRI 2 years postoperatively. Graft thickness was measured separately by two musculoskeletal radiologists. The MRI findings of graft disruption, signal intensity (SI) changes, cystic degeneration, arthrofibrosis, and impingement were analyzed. The statistical significance of the association between MRI findings was calculated. The mean anteromedial (AM) graft thickness was reduced 9% and the mean posterolateral (PL) graft thickness was reduced 18% from the original graft thickness. Disruption was seen in 3% of AM grafts and 6% of PL grafts and a partial tear in 8 and 23%, respectively. Both grafts were disrupted in 3% of patients. Increased SI was seen in 14% of intact AM grafts and in 60% of partially torn AM grafts (p = 0.032). In PL grafts the increased SI was seen in 51% of the intact grafts and in 93% of the partially torn grafts (p = 0.005). Cystic degeneration was seen in 8% of AM grafts and in 5% of PL grafts. Diffuse arthrofibrosis was seen in 5% of patients and a localized cyclops lesion in 3% of patients. Impingement of the AM graft was seen in 8% of patients. Both grafts were disrupted in 3% of patients. Also, the frequencies of other complications were low. The use of orthogonal sequences in the evaluation of the PL graft SI seems to cause volume-averaging artefacts. (orig.)

  14. Acrylic acid grafted PDMS preliminary activated by Ar+beam plasma and cell observation

    International Nuclear Information System (INIS)

    Plasma based Ar+ beam performed in RF (13.56 MHz) low-pressure (200 mTorr) glow discharge (at 100 W, 1200 W and 2500 W) with a serial capacitance was employed for surface modification of poly(dimethylsiloxane) (PDMS) aimed at improvement of its interactions with living cells. The presence of a serial capacitance ensures arise of an ion-flow inside the plasma volume directed toward the treated sample and the vary of the discharge power ensures varied density of the ion-flow The initial adhesion of human fibroblast cells was studied on the described above plasma based Ar+beam modified and acrylic acid (AA) grafted or not fibronectin (FN) pre-coated or ba resurfaces. The cell response seem sto be related with the peculiar structure and wettability of the modified PDMS surface layer after plasma based Ar+ beam treatment followed or not by AA grafting. Key words: Biomaterials; Surface treatment of PDMS; Plasma based Ar+ beam; Acrylic acid grafting; Fibroblast cells

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

    Energy Technology Data Exchange (ETDEWEB)

    He, Wentao; Wu, Danhua; Li, Juan; Zhang, Kai; Xiang, Yushu; Long, Lijuan; Qin, Shuhao; Yu, Jie; Zhang, Qin [Guizhou Univ., Guiyang (China)

    2013-09-15

    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 T{sup 2} and T{sup 3} except for Q{sup 2} and Q{sup 3} signals by CP/MAS {sup 29}Si 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.

  16. The role of MR imaging and cardio-pulmonary exercise test (CPET) in oncology patient - a case report

    International Nuclear Information System (INIS)

    Background: Thromboembolic complications are the second cause of mortality in patients with malignant neoplasms. Their course can be apparently asymptomatic, masked by other dominant symptoms of a malignant process. Therefore, there is a need for an unbiased diagnostic method to establish the causes of the patients' clinical condition. Case Report: The authors present a case of a 42-year-old neoplastic male patient admitted for bone marrow transplant. Examinations performed routinely before marrow transplantation showed pulmonary embolism in CT, while Trans Thoracic Echocardiography (TTE) revealed abnormal findings in the heart. Trans Esophageal Echocardiography (TEE) was indecisive and did not discriminate between a thrombus or neoplastic character of the observed pathological structures. MR helped to identify the findings as a thrombus. For unbiased initial assessment, the patient was referred for cardiopulmonary exercise test (CPET). Cardiopulmonary exercise test allowed to rule out any signs of restrictive or occlusive lung disease, and along with other diagnostic tests confirmed chronic thromboembolic pulmonary hypertension (CTEPH). Conclusions: Pulmonary embolism is found significantly more often in patients with neoplastic disease. Its course can be apparently asymptomatic, masked by other dominant symptoms of a malignant process. Magnetic resonance is a valuable tool in assessment of heart morphology, allowing proper diagnosis especially in thrombus identification, or detection of metastases. Cardiopulmonary exercise test can be useful in diagnosis and assessment of chronic thromboembolic pulmonary hypertension in apparently asymptomatic patients. CPET used in conjunction with MR seem to be a valuable combination capable of providing correct diagnosis where other methods fail. (author)

  17. Rational improvement of the affinity and selectivity of integrin binding of grafted lasso peptides.

    Science.gov (United States)

    Hegemann, Julian D; De Simone, Mariarosaria; Zimmermann, Marcel; Knappe, Thomas A; Xie, Xiulan; Di Leva, Francesco Saverio; Marinelli, Luciana; Novellino, Ettore; Zahler, Stefan; Kessler, Horst; Marahiel, Mohamed A

    2014-07-10

    Integrins moderate diverse important functions in the human body and are promising targets in cancer therapy. Hence, the selective inhibition of specific integrins is of great medicinal interest. Here, we report the optimization of a grafted lasso peptide, yielding MccJ25(RGDF), which is a highly potent and selective ?v?3 integrin inhibitor. Furthermore, its NMR structure was elucidated and employed in a molecular dynamics approach, revealing information about the integrin binding mode and selectivity profile of MccJ25(RGDF). PMID:24949551

  18. Rehabilitation after coronary artery by-pass grafting and improved quality of life.

    OpenAIRE

    Hoad, N A; Crawford, I C

    1990-01-01

    Long waiting lists for coronary artery by-pass grafting often mean that patients have to endure a prolonged period of pre-operative disability, a known poor prognostic factor for their future quality of life and employment prospects. A survey of 60 patients who attended a post-operative rehabilitation course designed to restore their fitness and self-esteem, and hence their quality of life, has shown encouraging results. When questioned a mean 16 months later, 85 per cent are working and sign...

  19. Cooperation between employers

    International Nuclear Information System (INIS)

    Guidance is given on the application of the Ionising Radiations Regulations 1985 (IRR 85) and the Ionising Radiations (Outside Workers) Regulations 1993 (OWRs) in circumstances where the operations of the employees of one organisation have the potential to expose to ionising radiation the employees of another. One of the Regulations of IRR 85 makes it mandatory for employers to cooperate in such circumstances. OWRs give more detailed requirements for the performance of the duties where one employers' classified employee works in another employer's controlled area. This document explains the separate responsibilities of site operators and contractors in situations where cooperation is required, and gives guidance on how it can be achieved. It also gives guidance to nuclear site licence holders regarding their duties under IRR 85 in such circumstances. (Author)

  20. Radiation-induced grafting of acrylamide onto guar gum in aqueous medium: Synthesis and characterization of grafted polymer guar-g-acrylamide

    Energy Technology Data Exchange (ETDEWEB)

    Biswal, Jayashree [Radiation Technology Development Section, Bhabha Atomic Research Centre, Trombay, Mumbai-400 085 (India); Kumar, Virendra [Radiation Technology Development Section, Bhabha Atomic Research Centre, Trombay, Mumbai-400 085 (India); Bhardwaj, Y.K. [Radiation Technology Development Section, Bhabha Atomic Research Centre, Trombay, Mumbai-400 085 (India)]. E-mail: ykbhard@magnum.barc.ernet.in; Goel, N.K. [Radiation Technology Development Section, Bhabha Atomic Research Centre, Trombay, Mumbai-400 085 (India); Dubey, K.A. [Radiation Technology Development Section, Bhabha Atomic Research Centre, Trombay, Mumbai-400 085 (India); Chaudhari, C.V. [Radiation Technology Development Section, Bhabha Atomic Research Centre, Trombay, Mumbai-400 085 (India); Sabharwal, S. [Radiation Technology Development Section, Bhabha Atomic Research Centre, Trombay, Mumbai-400 085 (India)

    2007-10-15

    Mutual radiation grafting technique has been applied to carry out grafting of acrylamide (AAm) onto guar gum (GG) using high-energy Co{sup 60} {gamma} radiation to enhance its flocculating properties for industrial effluents. The grafted product was characterized using analytical probes like elemental analysis, thermal analysis, Fourier transformed infrared (FTIR), X-ray diffraction (XRD) and scanning electron microscope (SEM). The grafting extent was observed to decrease with the dose rate and increase with the concentration of AAm. Thermo gravimetric analysis (TGA) of grafted and ungrafted samples indicated better stability of grafted product. {gamma} and microwave radiation effect on grafted and virgin GG has also been reported.