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Sample records for extracorporeal baboon liver

  1. Extracorporeal membrane oxygenation after living-related liver transplant.

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    Gedik, Ender; Çelik, Muhammet Reha; Otan, Emrah; Dişli, Olcay Murat; Erdil, Nevzat; Bayındır, Yaşar; Kutlu, Ramazan; Yılmaz, Sezai

    2015-04-01

    Various types of extracorporeal membrane oxygenation methods have been used in liver transplant operations. The main indications are portopulmonary or hepatopulmonary syndromes and other cardiorespiratory failure syndromes that are refractory to conventional therapy. There is little literature available about extracorporeal membrane oxygenation, especially after liver transplant. We describe our experience with 2 patients who had living-related liver transplant. A 69-year-old woman had refractory aspergillosis pneumonia and underwent pumpless extracorporeal lung assist therapy 4 weeks after liver transplant. An 8-month-old boy with biliary atresia underwent urgent liver transplant; he received venoarterial extracorporeal membrane oxygenation therapy on postoperative day 1. Despite our unsuccessful experience with 2 patients, extracorporeal membrane oxygenation and pumpless extracorporeal lung assist therapy for liver transplant patients may improve prognosis in selected cases.

  2. Mechanisms of xenogeneic baboon platelet aggregation and phagocytosis by porcine liver sinusoidal endothelial cells.

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    Qiang Peng

    Full Text Available BACKGROUND: Baboons receiving xenogeneic livers from wild type and transgenic pigs survive less than 10 days. One of the major issues is the early development of profound thrombocytopenia that results in fatal hemorrhage. Histological examination of xenotransplanted livers has shown baboon platelet activation, phagocytosis and sequestration within the sinusoids. In order to study the mechanisms of platelet consumption in liver xenotransplantation, we have developed an in vitro system to examine the interaction between pig endothelial cells with baboon platelets and to thereby identify molecular mechanisms and therapies. METHODS: Fresh pig hepatocytes, liver sinusoidal and aortic endothelial cells were isolated by collagenase digestion of livers and processing of aortae from GTKO and Gal+ MGH-miniature swine. These primary cell cultures were then tested for the differential ability to induce baboon or pig platelet aggregation. Phagocytosis was evaluated by direct observation of CFSE labeled-platelets, which are incubated with endothelial cells under confocal light microscopy. Aurintricarboxylic acid (GpIb antagonist blocking interactions with von Willebrand factor/vWF, eptifibatide (Gp IIb/IIIa antagonist, and anti-Mac-1 Ab (anti-α(Mβ(2 integrin Ab were tested for the ability to inhibit phagocytosis. RESULTS: None of the pig cells induced aggregation or phagocytosis of porcine platelets. However, pig hepatocytes, liver sinusoidal and aortic endothelial cells (GTKO and Gal+ all induced moderate aggregation of baboon platelets. Importantly, pig liver sinusoidal endothelial cells efficiently phagocytosed baboon platelets, while pig aortic endothelial cells and hepatocytes had minimal effects on platelet numbers. Anti-MAC-1 Ab, aurintricarboxylic acid or eptifibatide, significantly decreased baboon platelet phagocytosis by pig liver endothelial cells (P<0.01. CONCLUSIONS: Although pig hepatocytes and aortic endothelial cells directly caused

  3. Liver fibrosis after extracorporeal shock-wave lithotripsy of gallbladder stones - A case report

    NARCIS (Netherlands)

    P.W. Plaisier; J.F. Hamming (Jaap); R.L. van der Hul (René); R. den Toom (Rene); H.A. Bruining (Hajo)

    1994-01-01

    textabstractWe encountered significant liver fibrosis in a healthy young patient undergoing laparoscopic cholecystectomy for symptomatic gallstone disease. Twelve months prior to cholecystectomy the patient underwent multiple extracorporeal shock-wave lithotripsy (ESWL) sessions with adjuvant oral b

  4. Extracorporeal liver support therapy with Prometheus in patients with liver failure in the intensive care unit.

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    Oppert, Michael; Rademacher, Sibylle; Petrasch, Kathrin; Jörres, Achim

    2009-10-01

    Acute liver failure (ALF) and acute-on-chronic liver failure (AoCLF) are associated with a high mortality. In these patients an accumulation of both water-soluble and water-insoluble, protein-bound, metabolic waste products occurs. Conventional extracorporeal blood purification techniques based on diffusion and/or convection such as hemodialysis or hemofiltration may only eliminate small molecular weight, water-soluble compounds. In recent years, fractionated plasma separation and adsorption (FPSA) with the Prometheus system has been introduced for extracorporeal liver support therapy. To date, however, only limited data is available regarding the effect of this treatment on mortality and outcome of patients with advanced liver disease. Here we report on our experience with 23 patients with severe liver failure who were treated with Prometheus in our medical intensive care unit. Fourteen patients had AoCLF, and nine patients experienced ALF. The median bilirubin level at the start of Prometheus therapy was 30.5 mg/dL and the median Acute Physiology and Chronic Health Evaluation II (APACHE II) score was 26. During 40 individual treatment sessions lasting 5-6 h, Prometheus therapy reduced serum bilirubin levels from 23.7 mg/dL to 15.0 mg/dL (median values) (P Prometheus therapy was well tolerated without relevant side-effects. In conclusion, extracorporeal liver support therapy with Prometheus is a novel and safe treatment option in patients with severe liver failure. In this series, patients with ALF showed a significantly better outcome with Prometheus therapy compared to AoCLF patients.

  5. Clinical analysis and prognostic judgment of artificial extracorporeal liver support therapy for pediatric acute liver failure

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    ZHANG Zhen

    2015-08-01

    Full Text Available Objective To observe the clinical efficacy of artificial extracorporeal liver support therapy in the treatment of pediatric acute liver failure (PALF and to analyze the associated prognostic factors. Methods The clinical records of 23 patients with PALF treated from January 2012 to February 2015 in the Pediatric Intensive Care Unit of the First Hospital of Jilin University were analyzed retrospectively. After three-month follow-up, 15 patients survived (survival group, n=15, while 8 patients died (death group, n=8. The changes in biomarkers of liver function and coagulation function after treatment were evaluated within groups. At the same time, the above parameters and Model for End-Stage Liver Disease (MELD score before treatment were compared between the two groups. The efficacy of artificial extracorporeal liver support therapy was analyzed, and the prognostic factors were reviewed. The t test was applied in the comparison of continuous data. Results In the survival group, the levels of serum alanine aminotransferase (ALT, total bilirubin (TBil, ammonia, and lactic acid were significantly reduced after treatment (t=8.812, 6.243, 8.431, and 6.721, respectively; all P<0.01. However, in the death group, only ALT level was significantly reduced after treatment (t=2.532, P<0.05. Compared with the levels before treatment, the levels of prothrombin time (PT, prothrombin time activity (PTA, and international normalized ratio (INR were significantly improved after treatment (t=6.256, -2.738, and 6.711, respectively; all P<0.05. Before treatment, compared with the survival group, patients in the death group presented significantly lower level of ALT (t=6.283,P<0.01, significantly higher level of TBil (t=-3.938, P=0.001, significantly longer PT (t=-2.394, P=0.026, and significantly higher MELD score (t=-6.239, P<0.01. Conclusion Artificial extracorporeal liver support therapy is an effective way of treating PALF. Once patients with high ALT level

  6. Preservation of non-heart-beating donor livers in extracorporeal liver perfusion and histidine-trytophan-ketoglutarate solution.

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    Gong, Jin; Lao, Xue-Jun; Wang, Xi-Mo; Long, Gang; Jiang, Tao; Chen, Shi

    2008-04-21

    To compare the preservation of non-heart-beating donor (NHBD) livers in cold histidine-trytophan-ketoglutarate (HTK) solution and extracorporeal liver perfusion (ECLP). Livers harvested from healthy pigs were stored for 10 h in cold HTK solution (group A, n = 4) or perfused with oxygenated autologous blood at body temperature (group B, n = 4). Both groups were then tested on the circuit for 4 h. Bile production, hemodynamic parameters, hepatocyte markers and reperfusion injury of extracorporeal livers were tested in each group. Liver tissues from each group were examined at the end of reperfusion. At 1, 2, 3 and 4 h after reperfusion, bile production, hemodynamic parameters, hepatocyte markers and reperfusion injury of livers in group A were statistically different from those in group B (P < 0.05 or P < 0.01). ECLP is better than HTK solution to preserve NHBD livers. ECLP can assess the graft viability before liver transplantation.

  7. Extracorporeal support with a cadaver liver as a bridge to transplantation.

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    Fristoe, L W; Merrill, J H; Kangas, J A; Vogel, J E; Stammers, A H; Langnas, A N; Fox, I J; Shaw, B W

    1993-01-01

    Extracorporeal liver perfusion (ECLP) has been used for detoxifying blood in patients in class IV hepatic encephalopathy. Palliation of the moribund patient utilizing extracorporeal devices with cross-circulation of a cadaver liver has been documented for over three decades. Common problems associated with this procedure which appear in the literature include cadaver liver distention, increased resistance to blood flow, and limited time of extracorporeal support due to cadaver liver failure. This report summarizes the experiences of the perfusion team in utilizing an extracorporeal circuit with an otherwise nontransplantable cadaveric liver, to support the decompensating hepatic patient as a bridge to transplantation. Between January and July 1992, three patients were supported for hepatic failure with ECLP. Two patients were placed on ECLP with a modified circuit containing two positive displacement pumps and one centrifugal pump. The third patient was placed on ECLP with a circuit that contained two centrifugal pumps and one positive displacement pump. Patient age ranged from 6 to 38 years and length of support ranged from 24 to 72 hours. In all three patients, a centrifugal pump was placed in the suprahepatic inferior vena cava line to facilitate cadaver liver drainage and decompression. Intensive monitoring of both patient and cadaver liver hemodynamics, hepatic function, and hematological status was performed. All three patients were successfully weaned from ECLP. Two patients received successful orthotopic liver transplantation. The third died of complications unrelated to ECLP after support was discontinued.(ABSTRACT TRUNCATED AT 250 WORDS)

  8. Establishment and evaluation of the system of extracorporeal liver perfusion in pigs.

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    Gong, Jin; Wang, Xi-Mo; Long, Gang; Guo, Zhong-Tao; Jiang, Tao; Chen, Shi

    2005-02-01

    In recent years, extracorporeal liver perfusion (ECLP) has been regarded as a treatment of acute liver failure (ALF); but the system of ECLP has many problems. The purpose of this experiment was to detect the factors affecting the system of ECLP and to establish a stable and effective system of ECLP. Livers were harvested from health pigs, according to the different styles of perfusion and oxygenation, which were randomly divided into 3 groups. The livers in group A (n=4) were subjected to single portal vein perfusion, oxygenating perfusion blood; the livers in group B (n=4) to dual (portal vein and hepatic artery) vessel perfusion, oxygenating blood, together; and the livers in group C (n=4) to dual (portal vein and hepatic artery) vessel perfusion, but oxygenating blood, separately. The perfusion time, the data of bile production, and hemodynamic parameters of extracorporeal livers in each group were tested. The histological examination of liver tissues from each group was performed at the end of perfusion. The perfusion time of the liver in group A is significantly shorter than in groups B and C (P0.05). But at 12 hours after perfusion, the data of group B were statistically different from those of livers in group C (Pportal vein and hepatic artery) vessel perfusion and oxygenating blood separately, is more stable and effective to keep the function of extracorporeal liver.

  9. Extracorporeal support for patients with acute and acute on chronic liver failure.

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    Aron, Jonathan; Agarwal, Banwari; Davenport, Andrew

    2016-01-01

    The number of patients developing liver failure; acute on chronic liver failure and acute liver failure continues to increase, along with the demand for donor livers for transplantation. As such there is a clinical need to develop effective extracorporeal devices to support patients with acute liver failure or acute-on-chronic liver failure to allow time for hepatocyte regeneration, and so avoiding the need for liver transplantation, or to bridge the patient to liver transplantation, and also potentially to provide symptomatic relief for patients with cirrhosis not suitable for transplantation. Currently devices can be divided into those designed to remove toxins, including plasma exchange, high permeability dialyzers and adsorption columns or membranes, coupled with replacement of plasma proteins; albumin dialysis systems; and bioartificial devices which may provide some of the biological functions of the liver. In the future we expect combinations of these devices in clinical practice, due to the developments in bioartificial scaffolds.

  10. TREATMENT OF CANINE ACUTE LIVER FAILURE WITH MODIFIED EXTRACORPOREAL PIGLIVER PERFUSION

    Institute of Scientific and Technical Information of China (English)

    王博; 吕毅; 刘昌; 仵正; 潘承恩

    2003-01-01

    Objective To study the theraputic effect of extracorporeal liver perfusion on the treatment of acute liver failure. Methods Mongrel dogs weighing 12-14*!kg were selected. Hepatic failure was induced by an end-to-side portacaval shunt. The common hepatic and gastroduodenal arteries were occluded for 2 hours. To the control group (n=7), the dogs received standard medical therapy . To the treating group (n=10), the dogs received extracorporeal kidney and liver perfusion at the onset of the occlusion of the hepatic artery. During the liver support, the animals were frequently monitored regarding their clinical state, liver function, biochemical and hematological parameters. Results After the occlusion of the liver blood flow, all dogs died within 3-7.5 hours. The average survival time was (5.7±1.2) hours. Serum levels of ALT, AST, LDH and ammonia increased significantly. In the treating group, the dogs died within 7-10.5 hours. The average survival time was 8.6±1.1 hours. There were no significant diferences in serum levels of ALT, AST, LDH between the two groups(P>0.05). There were dramatic diferences in blood Ammonia level, PT, FIB between the two groups(P<0.05). The survival time was longer in treating group. The animals' blood pressure were more stable in the treating group than that in the control group. Conclusion The modified xenogenic liver perfusion can provide necessary hepatic function for the acute liver failure dogs.

  11. Extracorporeal perfusion for the treatment of acute liver failure

    NARCIS (Netherlands)

    H.B.A.C. Stockmann; C.A. Hiemstra; R.L. Marquet (Richard); J.N.M. IJzermans (Jan)

    2000-01-01

    textabstractOBJECTIVE AND SUMMARY BACKGROUND DATA: Because of the shortage of available donor organs, death rates from liver failure remain high. Therefore, several temporary liver-assisting therapies have been developed. This article reviews various approaches to

  12. Extracorporeal perfusion for the treatment of acute liver failure

    NARCIS (Netherlands)

    H.B.A.C. Stockmann; C.A. Hiemstra; R.L. Marquet (Richard); J.N.M. IJzermans (Jan)

    2000-01-01

    textabstractOBJECTIVE AND SUMMARY BACKGROUND DATA: Because of the shortage of available donor organs, death rates from liver failure remain high. Therefore, several temporary liver-assisting therapies have been developed. This article reviews various approaches to tempo

  13. Effect of extracorporeal bioartificial liver support system on fulminant hepatic failure rabbits

    Institute of Scientific and Technical Information of China (English)

    Ying Jie Wang; Meng Dong Li; Yu Ming Wang; Guo Zheng Chen; Guo Dong Lu; Zao Xia Tan

    2000-01-01

    AIM To evaluate the possibility of using cultured human hepatocytes as a bridge between bioartificial liver and liver transplantation. METHODS In this experiment, the efficacy of extracorporeal bioartificial liver support system (EBLSS) consisting of spheriodal human liver cells and cultured hepatocytes supernatant was assessed in vivo using galactosamine induced rabbit model of fulminant hepatic failure. RiESULTS There was no difference of survival between the two groups of rabbits, but in the supported rabbits serum alanine aminotransferase, total bilirubin and creatinine were significantly lower and hepatocyte necrosis was markedly milder than those in control animals. In addition, a good viability of human liver cells was noted after the experiment. CONCLUSION EBLSS plays a biologic role in maintaining and compensating the function of the liver.

  14. Technology insight: artificial extracorporeal liver support--how does Prometheus compare with MARS?

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    Krisper, Peter; Stauber, Rudolf E

    2007-05-01

    Artificial extracorporeal liver support or 'liver dialysis' has been used in patients with severe liver failure with increasing frequency since the Molecular Adsorbents Recirculating System (MARS), a variant of albumin dialysis, was introduced in 1999. Nevertheless, liver dialysis must still be thought of as experimental because its contribution to improved patient survival has not been proven in large randomized trials. Prometheus is a novel device for fractionated plasma separation via an albumin-permeable filter that was developed to improve removal of albumin-bound toxins. Initial studies have proven clinical use of Prometheus to be feasible and safe. Head-to-head comparisons of Prometheus and MARS have shown treatment with the former to be more efficient with respect to removal of most albumin-bound and water-solved markers. As controlled studies with clinical end points are lacking, it is not known whether the observed greater detoxification capacity of Prometheus will translate into clinical benefit; two small studies indicate that there might be a beneficial effect in hepatic encephalopathy and pruritus. In a recent randomized comparison of MARS and Prometheus, however, hemodynamic improvement was observed in response to MARS, but not Prometheus, treatment. A large randomized controlled trial investigating the effect of Prometheus on survival--the HELIOS study--has been initiated. First results are expected in 2008 and will be crucial to establishing a role for Prometheus in the field of extracorporeal liver support.

  15. Extracorporeal portal vein oxygenation improves outcome of acute liver failure in swine.

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    Nardo, B; Tsivian, M; Neri, F; Piras, G; Pariali, M; Bertelli, R; Cavallari, G

    2008-01-01

    Portal vein arterialization (PVA) has shown efficacy to treat acute liver failure (ALF) in preclinical studies. The next step is to perform large animal studies that propose a clinically acceptable method of PVA. In this study, we assessed the efficacy of PVA using an extracorporeal device to treat 2 ALF models in swine. The 2 ALF swine models were carbon tetrachloride toxic ALF and subtotal hepatectomy using 8 animals per group. PVA was performed with an extracorporeal device that may be suitable for future clinical studies. Arterial blood was drawn from the iliac artery and delivered into the portal vein for a 6-hour treatment. We analyzed biochemical, blood gas, and histological parameters as well as 1-week survival rates. In both models, ALF was successfully achieved. Control group animals deteriorated biochemically, dropping their prothrombin times and increasing the liver enzymes. In contrast, treated animals improved with a survival rate of 75% at 7 days compared with 0% for the former group. PVA using an extracorporeal device was feasible and effective to treat both toxic and resective ALF in swine.

  16. Establishment of extracorporeal circulation of artificial liver support system in high altitude region

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    Ming-sen ZHANG

    2011-01-01

    Full Text Available Objective To establish extracorporeal circulation in big animal suitable for the research on artificial liver support system in high altitude region.Methods Under the anesthesia of ketamine hydrochloride/diazepam IV,cannulation of common carotid artery/external jugular vein(n=3 and inferior vena cava via the left external jugular vein/right external jugular vein(n=3,was respectively performed on six healthy Chang-Bai piglets adapted to native environment(altitude 3700m.One day after that,the extracorporeal circulation was performed at a progressively elevated blood current velocity,and the general condition of the animals,blood pressure,HR,bleeding tendoncy of the experimental pigs and coagulation in the cannulae were observed.Results On the premise that the hemodynamics was not influenced,the highest blood current velocity was 133.33±28.87ml/min,the lowest heparin maintaining speed amounted to 138.67±12.22mg/h,and the bleeding tendency and blood coagulation in the cannula was significant in the group of common carotid artery/external jugular vein intubation.While the highest blood current velocity was 400ml/min,the lowest heparin maintaining speed was 26.67±9.24mg/h,no bleeding tendency or obvious cannular blood coagulation were observed in the group of cannulation of inferior vena cava via the left external jugular vein/right external jugular vein.These untoward results were significantly less or slight than that of the former group(P < 0.01.Conclusion It is suitable to perform research of artificial liver support system on piglets in high altitude region by establishing extracorporeal circulation by the way of inferior vena cava with cannulation passing through the left external jugular vein/right external jugular vein with the blood current velocity of 400ml/min.

  17. Iloprost donor treatment reduces ischemia-reperfusion injury in an isolated extracorporeal pig liver perfusion model.

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    Schoening, Wenzel N; Feige, Ines; Schubert, Thomas; Olschewski, Peter; Buescher, Niklas; Helbig, Michael; Schmitz, Volker; Neuhaus, Peter; Pratschke, Johann; Puhl, Gero

    2015-02-01

    Iloprost has the potential to protect the liver transplant graft before and during cold ischemia. We studied iloprost administration during organ procurement and reperfusion in an extracorporeal pig liver perfusion model. German Landrace pigs (n = 7/group; 22-26 kg each) were used as donors. Preservation was performed by aortic perfusion with 2 L Bretschneiders' Histidine-Tryptophan-Ketoglutarate solution HTK and cold ischemia time (4°C) 20 hours followed by normothermic extracorporeal perfusion for 8 hours. Untreated controls (1) were compared to iloprost (2) donor bolus-treatment (1 μg/kg body weight), (3) addition of iloprost to Bretschneiders' Histidine-Tryptophan-Ketoglutarate solution HTK (0.0125 μg/mL), (4) continuous infusion during reperfusion (2 ng/kg/min), and (5) combined treatment (2) and (4). Iloprost donor treatment led to significantly higher bile production. Addition of iloprost to the preservation solution significantly improved hepatic artery perfusion and was accompanied by improvements of microcirculation and bile production. Iloprost reperfusion treatment alone significantly improved bile production. Enzyme levels were positively affected by all treatment regimens. Combined use of iloprost before and after ischemia improved hepatic artery flow and microcirculation and showed significantly lower hypoxia staining versus controls. Iloprost donor treatment and use of iloprost in the preservation solution significantly improved graft perfusion and function. The effects of graft treatment seemed greater before than after reperfusion. Combined treatment did not reveal a synergistic advantage.

  18. The Prometheus device for extracorporeal support of combined liver and renal failure.

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    Rifai, Kinan; Ernst, Thomas; Kretschmer, Ulrich; Hafer, Carsten; Haller, Hermann; Manns, Michael Peter; Fliser, Danilo

    2005-01-01

    Prometheus is a newly developed extracorporeal liver support system that combines removal of albumin-bound substances (adsorption on resin adsorbers) and water-soluble substances (diffusion during high-flux hemodialysis). Therefore, it is a promising treatment option for patients with hepatorenal syndrome (HRS). We studied 10 patients with HRS in a prospective clinical study. All patients underwent 2 consecutive Prometheus treatments. A variety of clinical and biochemical parameters were assessed. Prometheus treatment was uncomplicated and safe. A statistically significant improvement of serum creatinine and urea concentrations as well as blood pH was observed after Prometheus treatment. Furthermore, liver detoxification was supported by a significant decrease of serum levels of conjugated bilirubin, bile acids and ammonia. Prometheus is a safe treatment for patients with HRS. Both, albumin-bound and water-soluble substances were effectively removed. Controlled studies will evaluate the effect of this new treatment option on survival in patients with HRS. (c) 2005 S. Karger AG, Basel.

  19. Removal selectivity of Prometheus: A new extracorporeal liver support device

    Institute of Scientific and Technical Information of China (English)

    Kinan Rifai; Thomas Ernst; Ulrich Kretschmer; Hermann Haller; Michael Peter Manns; Danilo Fliser

    2006-01-01

    AIM: To evaluate whether treatment with the Prometheus(R) system significantly affects cytokines,coagulation factors and other plasma proteins.METHODS: We studied nine patients with acute-onchronic liver failure and accompanying renal failure.Prometheus(R) therapy was performed on 2 consecutive days for up to 6 h in all patients. Several biochemical parameters and blood counts were assessed at regular time points during Prometheus(R) treatment.RESULTS: We observed a significant decrease of both protein-bound (e.g. Bile acids) and water-soluble (e.g.ammonia) substances after Prometheus(R) therapy. Even though leukocytes increased during treatment (P< 0.01),we found no significant changes of C-reactive protein,interleukin-6, and tumor necrosis factor-α plasma levels (all P > 0.5). Further, antithrombin 3, factor Ⅱ and factor V plasma levels did not decrease during Prometheus(R)therapy (all P >0.5), and the INR remained unchanged (P =0.4). Plasma levels of total protein, albumin, and fibrinogen were also not altered during Prometheus(R)treatment (all P > 0.5). Finally, platelet count did not change significantly during therapy (P= 0.6).CONCLUSION: Despite significant removal of proteinbound and water-soluble substances, Prometheus(R)therapy did not affect the level of cytokines, coagulation factors or other plasma proteins. Thus, the filters and adsorbers used in the system are highly effective and specific for water-soluble substances and toxins bound to the albumin fraction.

  20. An experimental pilot study on controlled portal vein arterialization with an extracorporeal device in the swine model of partial liver resection and ischemia.

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    Nardo, B; Montalti, R; Puviani, L; Pacilè, V; Beltempo, P; Bertelli, R; Licursi, M; Pariali, M; Cianciavicchia, D

    2006-09-01

    To determine whether the physiologically oxygenated arterial blood reversed in the portal system by means of portal vein arterialization (PVA) through an extracorporeal device which we have called L.E.O2.NARDO (Liver Extracorporeal Oxygen. NARDO) is effective in treating swine with subtotal hepatectomy leading to acute liver failure (ALF). Ten swine with ALF induced by 85-90% liver resection and five minutes of ischemia-reperfusion injury were randomly divided into two groups: five animals received PVA extracorporeal treatment and five swine were not-treated (control group). Blood was withdrawn from the iliac artery and reversed in the portal venous system. An extracorporeal device was interposed between the outflow and the inflow in order to monitoring the hemodynamic parameters. Each treatment lasted 6 hours. Serum and liver samples were collected in both groups. The survival was assessed at 1 week. The PVA-extracorporeal treatment yielded beneficial effects for subtotal hepatectomy-induced ALF swine with decreased serum ammonia, transaminases and total bilirubin as compared with the untreated group. INR recovered rapidly in the PVA-extracorporeal group remaining significantly lower than in untreated animals. The 7-day survival of PVA-extracorporeal group swine was significantly higher than that of untreated animals, with a statistically significant difference (pportal system through the extracorporeal device is easily applicable, efficacious, safe and may represent a novel approach for ALF swine induced by subtotal liver resection.

  1. Prometheus--a new extracorporeal system for the treatment of liver failure.

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    Rifai, Kinan; Ernst, Thomas; Kretschmer, Ulrich; Bahr, Matthias J; Schneider, Andrea; Hafer, Carsten; Haller, Hermann; Manns, Michael P; Fliser, Danilo

    2003-12-01

    Extracorporeal detoxification systems for supportive therapy of liver failure have recently gained much interest. We herein report results from the first clinical application of Prometheus, a new liver support system in which albumin-bound substances are directly removed from blood by special adsorber. In a simultaneous step, high-flux hemodialysis is performed. We assessed safety, adsorber efficiency and clinical efficacy of the Prometheus system. Eleven patients with acute-on-chronic liver failure and accompanying renal failure were treated with Prometheus on 2 consecutive days for >4 h. Prometheus treatment significantly improved serum levels of conjugated bilirubin, bile acids, ammonia, cholinesterase, creatinine, urea and blood pH. There were no significant changes in hemoglobin and platelet levels, whereas leucocytes increased without signs of systemic infection. No treatment-related complications except a blood pressure drop in two patients with systemic infection were noted. In one patient (Child-Pugh score: 15) Prometheus treatment could not be completed due to onset of uncontrolled bleeding 16 h after dialysis. Prometheus is a safe supportive therapy for patients with liver failure. A significant improvement of the biochemical milieu was observed already after two treatments. Prospective controlled studies with the Prometheus system are necessary to evaluate hard clinical end-points.

  2. Up to 9-day survival and control of thrombocytopenia following alpha1,3-galactosyl transferase knockout swine liver xenotransplantation in baboons.

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    Kim, Karen; Schuetz, Christian; Elias, Nahel; Veillette, Gregory R; Wamala, Isaac; Varma, Manish; Smith, R Neal; Robson, Simon C; Cosimi, A Benedict; Sachs, David H; Hertl, Martin

    2012-01-01

    With standard miniature swine donors, survivals of only 3 days have been achieved in primate liver-transplant recipients. The recent production of alpha1,3-galactosyl transferase knockout (GalT-KO) miniature swine has made it possible to evaluate xenotransplantation of pig organs in clinically relevant pig-to-non-human primate models in the absence of the effects of natural anti-Gal antibodies. We are reporting our results using GalT-KO liver grafts. We performed GalT-KO liver transplants in baboons using an immunosuppressive regimen previously used by our group in xeno heart and kidney transplantation. Post-operative liver function was assessed by laboratory function tests, coagulation parameters and histology. In two hepatectomized recipients of GalT-KO grafts, post-transplant liver function returned rapidly to normal. Over the first few days, the synthetic products of the donor swine graft appeared to replace those of the baboon. The first recipient survived for 6 days and showed no histopathological evidence of rejection at the time of death from uncontrolled bleeding, probably caused by transfusion-refractory thrombocytopenia. Amicar treatment of the second and third recipients led to maintenance of platelet counts of over 40 000 per μl throughout their 9- and 8-day survivals, which represents the longest reported survival of pig-to-primate liver transplants to date. Both of the last two animals nevertheless succumbed to bleeding and enterococcal infection, without evidence of rejection. These observations suggest that thrombocytopenia after liver xenotransplantation may be overcome by Amicar therapy. The coagulopathy and sepsis that nevertheless occurred suggest that additional causes of coagulation disturbance must be addressed, along with better prevention of infection, to achieve long-term survival. © 2012 John Wiley & Sons A/S.

  3. Extracorporeal Membrane Oxygenation Can Save Lives in Children With Heart or Lung Failure After Liver Transplantation.

    Science.gov (United States)

    Jean, Sandrine; Chardot, Christophe; Oualha, Mehdi; Capito, Carmen; Bustarret, Olivier; Pouard, Philippe; Renolleau, Sylvain; Lacaille, Florence; Dupic, Laurent

    2017-09-01

    The risk of cardiac or lung failure after liver transplantation (LT) is significant. In rare cases, the usual intensive care techniques fail to maintain organ oxygenation with a risk of multiorgan dysfunction. Although extracorporeal membrane oxygenation (ECMO) is a difficult and risky procedure, it can be proposed as life-saving. Four children with either acute pulmonary (three) or cardiac (one) failure after LT, and the criteria that decided the use of ECMO (level of ventilation and results, dosage of inotropic drugs, cardiac ultrasound, blood lactate) were retrospectively reported. These patients, 1-11 years old, were treated with either veno-arterial (three) or veno-venous (one) ECMO. Two experienced a full recovery, with 3 and 6 years of follow-up. Two died of systemic inflammatory response syndrome (SIRS) due to ECMO, and relapse of heart failure due to the underlying disease. Although our patients' survival was only 50%, we showed that ECMO can be useful in children after LT. It should be considered before the development of irreversible multiorgan failure. © 2017 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

  4. Extended liver storage. Development and optimization of liver preservation and extracorporeal machine perfusion

    NARCIS (Netherlands)

    Berendsen, T.A.

    2014-01-01

    This work focuses on the improvement of liver graft quality through the use of MP. It has been established that intracellular ATP is a significant measure of the cellular viability of an explanted organ. Chapter 1 examines the relationship between intracellular ATP and cellular viability at differen

  5. An Evaluation of the Usefulness of Extracorporeal Liver Support Techniques in Patients Hospitalized in the ICU for Severe Liver Dysfunction Secondary to Alcoholic Liver Disease

    Directory of Open Access Journals (Sweden)

    Piechota

    2016-07-01

    Full Text Available Background The mortality rate in patients with severe liver dysfunction secondary to alcoholic liver disease (ALD who do not respond to the standard treatment is exceptionally high. Objectives The main aim of this study was to evaluate the usefulness of applying extracorporeal liver support techniques to treat this group of patients. Patients and Methods The data from 23 hospital admissions of 21 patients with ALD who were admitted to the department of anesthesiology and intensive therapy (A&IT at the Dr Wł. Biegański Regional Specialist Hospital in Łódź between March 2013 and July 2015 were retrospectively analyzed. Results A total of 111 liver dialysis procedures were performed during the 23 hospitalizations, including 13 dialyses using fractionated plasma separation and adsorption (FPSA with the Prometheus® system, and 98 procedures using the single pass albumin dialysis (SPAD system. Upon admission to the intensive care unit (ICU, the median (interquartile range [IQR] Glasgow coma scale (GCS, sequential organ failure assessment (SOFA, acute physiology and chronic health evaluation (APACHE II, and simplified acute physiology score (SAPS II scores were 15 (14 - 15, 9 (7 - 13, 17 (14 - 24, and 32 (22 - 50, respectively. The ICU, 30-day, and three-month mortality rates were 43.48%, 39.13%, and 73.91%, respectively. As determined by the receiver operative characteristic (ROC analysis for single-factor models, the significant predictors of death in the ICU included the patients’ SOFA, APACHE II, SAPS II, and model of end-stage liver disease modified by the united network for organ sharing (MELD UNOS Modification scores; the duration of stay (in days in the A&IT Department; and bile acid, creatinine and albumin levels upon ICU admission. The ROC analysis indicated the significant discriminating power of the SOFA, APACHE II, SAPS II, and MELD UNOS modification scores on the three-month mortality rate. Conclusions The application of

  6. [Evaluation of a new technique of extracorporeal perfusion of the swine liver on a swine-primate model].

    Science.gov (United States)

    Beaufigeau, M; Wolf, P; Azimzadeh, A; Godfrin, Y; Beller, J P; Boudjema, K; Jaeck, D; Kieny, R; Cinqualbre, J

    1996-01-01

    With the increasing success of liver transplantation there is an urgent need for developing an artificial liver support system to be used in patients with liver failure. An extracorporeal porcine liver perfusion machine was successfully tested in animals with experimental liver failure. Livers were flushed, removed from 35 kg pigs and placed in a heated sterile cassette. The portal vein and the hepatic artery of the graft were connected to the arterial system of the animals. The perfusion pressure of the hepatic artery was regulated via a pressure-flow computerized feed-back device. The venous flow was reinfused from the hepatic veins of the graft to the jugular vein of the animals. The experimental work consisted in two steps: 1. evaluation of clinical and biological consequences of liver perfusion in healthy animals (Group A = pigs, n = 3; group B = primates, n = 3); 2. evaluation of the efficiency of the liver perfusion in animals with ischemic liver failure (Groupe D = pigs, n = 6). The control group (Group C = pigs, n = 7) consisted of pigs with ischemic liver failure without hepatic support. No major clinical or biological adverse effects are reported in groups A and B excepted a thrombocytmia and a marked increase in serum transaminases levels in group B. Liver function as assessed by the bile flow was good in both groups. Comatose pigs with ischemic hepatic failure (group D) recovered a subnormal neurological status in five out of six cases. Serum ammoniemia level were significantly decreased (from 1076 +/- 163 to 255 +/- 32 umol/l). A decrease in serum bilirubine levels and an improvement in the coagulation profile were observed in the perfused animals. Pigs and primates tolerated the perfusion procedure well and beneficial effects were observed in perfused pigs with experimental liver failure.

  7. Gel dosimetry in the BNCT facility for extra-corporeal treatment of liver cancer at the HFR Petten.

    Science.gov (United States)

    Gambarini, G; Daquino, G G; Moss, R L; Carrara, M; Nievaart, V A; Vanossi, E

    2007-01-01

    A thorough evaluation of the dose inside a specially designed and built facility for extra-corporeal treatment of liver cancer by boron neutron capture therapy (BNCT) at the High Flux Reactor (HFR) Petten (The Netherlands) is the necessary step before animal studies can start. The absorbed doses are measured by means of gel dosemeters, which help to validate the Monte Carlo simulations of the spheroidal liver holder that will contain the human liver for irradiation with an epithermal neutron beam. These dosemeters allow imaging of the dose due to gammas and to the charged particles produced by the (10)B reaction. The thermal neutron flux is extrapolated from the boron dose images and compared to that obtained by the calculations. As an additional reference, Au, Cu and Mn foil measurements are performed. All results appear consistent with the calculations and confirm that the BNCT liver facility is able to provide an almost homogeneous thermal neutron distribution in the liver, which is a requirement for a successful treatment of liver metastases.

  8. Bioartificial Therapy of Sepsis: Changes of Norepinephrine-Dosage in Patients and Influence on Dynamic and Cell Based Liver Tests during Extracorporeal Treatments

    Directory of Open Access Journals (Sweden)

    Martin Sauer

    2016-01-01

    Full Text Available Purpose. Granulocyte transfusions have been used to treat immune cell dysfunction in sepsis. A granulocyte bioreactor for the extracorporeal treatment of sepsis was tested in a prospective clinical study focusing on the dosage of norepinephrine in patients and influence on dynamic and cell based liver tests during extracorporeal therapies. Methods and Patients. Ten patients with severe sepsis were treated twice within 72 h with the system containing granulocytes from healthy donors. Survival, physiologic parameters, extended hemodynamic measurement, and the indocyanine green plasma disappearance rate (PDR were monitored. Plasma of patients before and after extracorporeal treatments were tested with a cell based biosensor for analysis of hepatotoxicity. Results. The observed mortality rate was 50% during stay in hospital. During the treatments, the norepinephrine-dosage could be significantly reduced while mean arterial pressure was stable. In the cell based analysis of hepatotoxicity, the viability and function of sensor-cells increased significantly during extracorporeal treatment in all patients and the PDR-values increased significantly between day 1 and day 7 only in survivors. Conclusion. The extracorporeal treatment with donor granulocytes showed promising effects on dosage of norepinephrine in patients, liver cell function, and viability in a cell based biosensor. Further studies with this approach are encouraged.

  9. Sexually dimorphic effects of maternal nutrient reduction on expression of genes regulating cortisol metabolism in fetal baboon adipose and liver tissues.

    Science.gov (United States)

    Guo, Chunming; Li, Cun; Myatt, Leslie; Nathanielsz, Peter W; Sun, Kang

    2013-04-01

    Maternal nutrient reduction (MNR) during fetal development may predispose offspring to chronic disease later in life. Increased regeneration of active glucocorticoids by 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) in metabolic tissues is fundamental to the developmental programming of metabolic syndrome, but underlying mechanisms are unknown. Hexose-6-phosphate dehydrogenase (H6PD) generates NADPH, the cofactor for 11β-HSD1 reductase activity. CCAAT/enhancer binding proteins (C/EBPs) and the glucocorticoid receptor (GR) regulate 11β-HSD1 expression. We hypothesize that MNR increases expression of fetal C/EBPs, GR, and H6PD, thereby increasing expression of 11β-HSD1 and reductase activity in fetal liver and adipose tissues. Pregnant MNR baboons ate 70% of what controls ate from 0.16 to 0.9 gestation (term, 184 days). Cortisol levels in maternal and fetal circulations increased in MNR pregnancies at 0.9 gestation. MNR increased expression of 11β-HSD1; H6PD; C/EBPα, -β, -γ; and GR in female but not male perirenal adipose tissue and in male but not female liver at 0.9 gestation. Local cortisol level and its targets PEPCK1 and PPARγ increased correspondingly in adipose and liver tissues. C/EBPα and GR were found to be bound to the 11β-HSD1 promoter. In conclusion, sex- and tissue-specific increases of 11β-HSD1, H6PD, GR, and C/EBPs may contribute to sexual dimorphism in the programming of exaggerated cortisol regeneration in liver and adipose tissues and offsprings' susceptibility to metabolic syndrome.

  10. Extracorporeal venous bypass in liver transplantation%肝移植手术中的体外静脉转流

    Institute of Scientific and Technical Information of China (English)

    黄伟明; 朱艳玲; 黄文起; 黄洁夫

    2000-01-01

    Objective To observe the effects of extracorporeal veno-venous bypass on hemodynamics,biochemistry,body temperature during liver transplantation.Methods Venovenous bypass with Sarns Delphin Ⅱ Centifugal pump,Sarns heat exchanger and partial heparinization was used in 8 cases undergoing allogenic orthotopic liver transplantation.Results The average time of extracorporeal venous bypass was (109±35)min.Perfusion flow rate was 300 to 1 000 ml/min.Mean arterial pressure(MAP)and CVP were maintained at 60 to 96 mm Hg and 4 to 14 cm H2O,respectively.The average nasopharyngeal temperature and ACT were maintained at(35.9±0.8)℃and(238±45)s.The results of blood gas analysis and biochemical test were normal.There was no cardiac arrhythmia.Conclusions The use of the centrifugal pump,heat exchanger and partial heparinization in extracorporeal veno-venous bypass may reduce the effects on the patients' hemodynamics and biochemistry.The technique can achieve good results in clinical practice.%目的 观察体外静脉一静脉转流对患者血流动力学、生化和体温的影响.方法 施行原位异体肝移植术8例,术中使用离心泵、血液变温器、部分肝素化方法行体外静脉转流.结果 体外静脉转流时间为:(109±35)min;灌注量300~1 000ml/min,平均动脉压(MaP)维持在60~96mm Hg(1mm Hg=0.133 kPa),中心静脉压(CVP)4~14 cm H2O,鼻咽温(35.9±0.8)℃,激活凝血时间(ACT)为:(238±45)S,血气及生化结果基本正常.停止转流后血流动力学稳定,未出现心律紊乱.结论 采用离心泵,血液变温器和部分肝素化的静脉转流方法可减少患者无肝期血流动力学、生化等方面的影响,临床效果好.

  11. Efficacy and safety of anticoagulation with heparin versus heparin plus epoprostenol in patients undergoing extracorporeal liver support with Prometheus.

    Science.gov (United States)

    Krisper, Peter; Tiran, Beate; Fliser, Danilo; Haditsch, Bernd; Stadlbauer, Vanessa; Otto, Ronald; Ernst, Thomas; Kretschmer, Ulrich; Stauber, Rudolf E; Haller, Hermann; Holzer, Herwig; Manns, Michael P; Rifai, Kinan

    2010-01-01

    Anticoagulation for extracorporeal liver support is delicate due to underlying coagulation disorders in patients with liver failure and to the associated elevated bleeding risk. To date, there has been no detailed report on anticoagulation issues in patients treated with Prometheus, a device based on the principle of fractionated plasma separation and adsorption. We studied 17 patients from two centers treated with Prometheus, comparing standard anticoagulation with heparin (15 treatments) and a combination of heparin and the synthetic prostacyclin epoprostenol (22 treatments). Standard coagulation tests, proteins C and S, and thrombin-antithrombin (TAT) complex were determined, and adverse events were recorded. All but two treatments could be completed as scheduled, although filter exchange due to filter clotting was required in 24% of the treatments. Three out of 17 patients developed severe bleeding complications within 24 h of treatment. There were no overt thrombotic events. Addition of epoprostenol neither reduced coagulation-related adverse events nor improved standard coagulation parameters. Protein C, but not protein S, showed a significant reduction (23 +/- 18%) after Prometheus treatments, but levels rebounded to baseline within 18 h. TAT levels--a measure for activation of coagulation--were only altered by Prometheus in patients where TAT was already elevated before treatment. In conclusion, anticoagulation of Prometheus with heparin is feasible but still associated with a relatively high frequency of filter clotting and a considerable risk of severe bleeding in this high-risk patient population. As addition of epoprostenol did not prove beneficial, other strategies, such as regional anticoagulation with citrate, should be further evaluated.

  12. Dosimetric feasibility study for an extracorporeal BNCT application on liver metastases at the TRIGA Mainz

    Energy Technology Data Exchange (ETDEWEB)

    Blaickner, M., E-mail: matthias.blaickner@ait.ac.at [Health and Environment Department-Molecular Medicine, AIT Austrian Institute of Technology GmbH, Muthgasse 11, A-1190 Vienna (Austria); Kratz, J.V. [Institut fuer Kernchemie, Johannes Gutenberg-Universitaet Mainz, Fritz-Strassmann-Weg 2, D-55128 Mainz (Germany); Minouchehr, S.; Otto, G. [Transplantationschirurgie, Universitaetsklinikum Mainz, Langenbeckstr.1, D-55131 Mainz (Germany); Schmidberger, H. [Klinik und Poliklinik fuer Radioonkologie und Strahlentherapie, Universitaetsklinikum Mainz, Langenbeckstr.1, D-55131 Mainz (Germany); Schuetz, C.; Vogtlaender, L. [Institut fuer Kernchemie, Johannes Gutenberg-Universitaet Mainz, Fritz-Strassmann-Weg 2, D-55128 Mainz (Germany); Wortmann, B. [Evonik Energy Services GmbH Essen, Ruettenscheider Str. 1-3, D-45128 Essen (Germany); Hampel, G. [Institut fuer Kernchemie, Johannes Gutenberg-Universitaet Mainz, Fritz-Strassmann-Weg 2, D-55128 Mainz (Germany)

    2012-01-15

    This study investigates the dosimetric feasibility of Boron Neutron Capture Therapy (BNCT) of explanted livers in the thermal column of the research reactor in Mainz. The Monte Carlo code MCNP5 is used to calculate the biologically weighted dose for different ratios of the {sup 10}B-concentration in tumour to normal liver tissue. The simulation results show that dosimetric goals are only partially met. To guarantee effective BNCT treatment the organ has to be better shielded from all gamma radiation. - Highlights: Black-Right-Pointing-Pointer Monte Carlo simulations demonstrate the potential for BNCT treatment at TRIGA Mainz. Black-Right-Pointing-Pointer Simulation shows the necessity of gamma shielding for the organ from all sides. Black-Right-Pointing-Pointer Secondary photons induced within the graphite contribute considerably to gamma dose.

  13. Effect of extracorporeal liver support by molecular adsorbents recirculating system and Prometheus on redox state of albumin in acute-on-chronic liver failure.

    Science.gov (United States)

    Oettl, Karl; Stadlbauer, Vanessa; Krisper, Peter; Stauber, Rudolf E

    2009-10-01

    Oxidative stress is believed to play an important role in acute-on-chronic liver failure (AoCLF). Albumin, an important transport vehicle, was found to be severely oxidized in AoCLF patients. Extracorporeal liver support systems may exert beneficial effects in AoCLF via removal of albumin-bound toxins. At present, two systems are commercially available, the molecular adsorbents recirculating system (MARS) and fractionated plasma separation, adsorption and dialysis (FPAD, also known as Prometheus). The aim of this study was to compare the effect of MARS and Prometheus treatments on the redox state of human serum albumin. Eight patients with AoCLF underwent alternating treatments with either MARS or Prometheus in a randomized cross-over design. Sixteen treatments (eight MARS and eight Prometheus) were available for analysis. The fraction of human mercaptalbumin (HMA), human nonmercaptalbumin-1 (HNA1), and human nonmercaptalbumin-2 (HNA2) were measured before and after single MARS and Prometheus treatments and during follow-up. In AoCLF patients the oxidized fractions of albumin, HNA1, and HNA2 were markedly increased. Both MARS and Prometheus treatments resulted in a shift of HNA1 to HMA, while HNA2 was not significantly affected. This shift in albumin fractions was transient and disappeared within 24 h after treatment. There were no significant differences between MARS and Prometheus treatments with respect to the redox state of albumin. Both MARS and Prometheus treatments lead to transient improvements of the redox state of albumin, which could be beneficial in the treatment of AoCLF.

  14. [Extracorporeal reconstruction of arteries of a transplant of the liver for its subsequent implantation and surgical aspects of arterial anatomy the hepatoduodenal area].

    Science.gov (United States)

    Khubutiia, M Sh; Guliaev, V A; Novruzbekov, M S; Lemenev, V L; Driaev, V T

    2014-01-01

    Orthotopic liver transplantation (OLT) remains the only and radical method of treating patients with terminal stages of chronic diffuse hepatic diseases (cirrhoses), of patients with various congenital metabolic lesions of the liver, autoimmune diseases characterized by lesions of bile ducts, as well as series of both primary and secondary tumorous hepatic lesions. Liver transplantation is one of the most complicated operative interventions. Difficulty of OLT is determined by multifactorial and well-coordinated work of various medical services at the pre-, intra- and postoperative stage of management. One of the important components of success in transplantation consists in providing adequate arterial blood flow of the transplanted organ, which is achieved by extracorporeal reconstruction of the transplant. Variants of arterial blood supply of the liver are observed in each third donor. These anatomical peculiarities increase probability of a surgical error, which is considerably higher if not taking into consideration the complicated anatomy of the donor organ and its misalignment with the anatomical peculiarities of the recipient. Surgeon's responsibility is especially great during taking out the liver from the donor, as well as during its preparation for implantation. Procurement of the liver and pancreas from the same donor for transplantation to two different recipients may be accompanied and followed by the so-called conflict of interests which the surgeon has to decide in favour of the both during procurement of the organ for its extracorporeal processing. The sequence of the presented surgical manipulations on hepatic and pancreatic vessels, as well as anatomical reference points make it possible to preserve the vessels of the maximum length for the both organs. A wide variety of the structure of hepatic vessels may be divided into three types, depending upon the number of the sources of arterial blood supply.

  15. The baboon syndrome

    DEFF Research Database (Denmark)

    Andersen, Klaus Ejner; Hjorth, N; Menné, T

    1984-01-01

    The catchword "baboon syndrome" is used to denote a characteristic distribution pattern of systemic allergic contact dermatitis. Diffuse erythema of the buttocks, upper inner surface of the thighs, and axillae are characteristic features. We describe 3 cases provoked by ampicillin, nickel...... and mercury. The condition may be overlooked and suspected of being a textile dermatitis or seborrhoeic dermatitis of the elderly....

  16. THE SUCCESSFUL TREATMENT OF A PERIPHERAL VENO-VENOUS EXTRACORPOREAL MEMBRANE OXYGENATION FOR SEVERE ACUTE RESPIRATORY FAILURE IN THE EARLY PERIOD AFTER ADULT LIVER TRANSPLANTATION

    Directory of Open Access Journals (Sweden)

    V. N. Poptsov

    2014-01-01

    Full Text Available Aim: of our clinical study was to present own experience of veno-venous extracorporeal membrane oxygenation (VV ECMO for the treatment of an adult patient (female, 28 yrs, 150 cm, 35 kg with acute respiratory distress syndrome (ARDS in the early period after liver transplantation against satisfactory liver graft function. Materials and methods. Double-lumen cannula 22 F was placed percutaneously in the right internal jugular vein. The ext- racorporeal contour reduced in length and the polymethylpeptene oxygenator (priming volume 175 ml were also. Results. In 1 hour after the beginning of VV ECMO, we registered the noted improvement of arterial blood gas and acid-base balance (regress of respiratory acidosis, improvement of arterial oxygenation which allowed us to use the «protective» mode of mechanical ventilation. Improvement of gas exchange and regress of clinical and radiological manifestations of ARDS allowed for VV ECMO weaning and decannulation on day 7. The patient was discharged from ICU and then from our Centre to a homestay respectively on the 9th and 16th day after VV ECMO weaning with the satisfactory liver graft and lungs function. Conclusion. VV ECMO can be successfully applied to correct the life-threatening acute respiratory failure in the early period after liver transplantation. 

  17. Design of a rotating facility for extracorporal treatment of an explanted liver with disseminated metastases by boron neutron capture therapy with an epithermal neutron beam.

    Science.gov (United States)

    Nievaart, V A; Moss, R L; Kloosterman, J L; van der Hagen, T H J J; van Dam, H; Wittig, A; Malago, M; Sauerwein, W

    2006-07-01

    In 2001, at the TRIGA reactor of the University of Pavia (Italy), a patient suffering from diffuse liver metastases from an adenocarcinoma of the sigmoid was successfully treated by boron neutron capture therapy (BNCT). The procedure involved boron infusion prior to hepatectomy, irradiation of the explanted liver at the thermal column of the reactor, and subsequent reimplantation. A complete response was observed. This encouraging outcome stimulated the Essen/Petten BNCT group to investigate whether such an extracorporal irradiation could be performed at the BNCT irradiation facility at the HFR Petten (The Netherlands), which has very different irradiation characteristics than the Pavia facility. A computational study has been carried out. A rotating PMMA container with a liver, surrounded by PMMA and graphite, is simulated using the Monte Carlo code MCNP. Due to the rotation and neutron moderation of the PMMA container, the initial epithermal neutron beam provides a nearly homogeneous thermal neutron field in the liver. The main conditions for treatment as reported from the Pavia experiment, i.e. a thermal neutron fluence of 4 x 10(12) +/- 20% cm(-2), can be closely met at the HFR in an acceptable time, which, depending on the defined conditions, is between 140 and 180 min.

  18. Effect of human patient plasma ex vivo treatment on gene expression and progenitor cell activation of primary human liver cells in multi-compartment 3D perfusion bioreactors for extra-corporeal liver support.

    Science.gov (United States)

    Schmelzer, Eva; Mutig, Kerim; Schrade, Petra; Bachmann, Sebastian; Gerlach, Jörg C; Zeilinger, Katrin

    2009-07-01

    Cultivation of primary human liver cells in innovative 3D perfusion multi-compartment capillary membrane bioreactors using decentralized mass exchange and integral oxygenation provides in vitro conditions close to the physiologic environment in vivo. While a few scale-up bioreactors were used clinically, inoculated liver progenitors in these bioreactors were not investigated. Therefore, we characterized regenerative processes and expression patterns of auto- and paracrine mediators involved in liver regeneration in bioreactors after patient treatment. Primary human liver cells containing parenchymal and non-parenchymal cells co-cultivated in bioreactors were used for clinical extra-corporeal liver support to bridge to liver transplantation. 3D tissue re-structuring in bioreactors was studied; expression of proteins and genes related to regenerative processes and hepatic progenitors was analyzed. Formation of multiple bile ductular networks and colonies of putative progenitors were observed within parenchymal cell aggregates. HGF was detected in scattered cells located close to vascular-like structures, expression of HGFA and c-Met was assigned to biliary cells and hepatocytes. Increased expression of genes associated to hepatic progenitors was detected following clinical application. The results confirm auto- and paracrine interactions between co-cultured cells in the bioreactor. The 3D bioreactor provides a valuable tool to study mechanisms of progenitor activation and hepatic regeneration ex vivo under patient plasma treatment. (c) 2009 Wiley Periodicals, Inc.

  19. Applicability of Combined Use of Extracorporeal Support and Temperature-Controlled Machine Perfusion Preservation for Liver Procurement of Donors After Cardiac Death in Pigs.

    Science.gov (United States)

    Hagiwara, M; Matsuno, N; Meng, L T; Furukori, M; Watanabe, K; Shonaka, T; Imai, K; Obara, H; Nishikawa, Y; Furukawa, H

    2016-05-01

    The use of grafts from donors after cardiac death (DCD) would greatly contribute to the expansion of the donor organ pool. The objective of this study is to determine the benefits of extracorporeal membrane oxygenation (ECMO) and subnormothermic machine perfusion (MP) with rewarming in a large animal model of DCD liver. After cardiac arrest, the abdominal aorta and the inferior vena cava were cannulated and connected to an ECMO circuit. Porcine livers were perfused in situ with ECMO at 22°C for 60 minutes after 60 minutes of cardiac death. Then the livers were perfused for 4 hours by MP as a graft viability test. In group 1, non-in situ ECMO and grafts were preserved hypothermic MP. In group 2, non-in situ ECMO and grafts were preserved subnormothermic rewarming MP. In group 3, we used ECMO and subnormothermic rewarming MP. To assess potential methods and effect, effluent enzymes were measured. Portal vein and hepatic artery pressure during MP were evaluated. Effluent enzyme of AST, alanine aminotransferase and LDH as viability markers were significantly low (aspartate aminotransferase, 2899, 2292, and 972 IU/L; alanine aminotransferase, 134, 140, and 72 IU/L; and lactate dehydrogenase, 4354, 4455, and 1855 IU/L in each group, respectively). Portal vein and hepatic artery pressure during preservation came down smoothly in group 3 compared with group 1. The combined use of in situ subnormothermic ECMO and machine preservation with rewarming is more essential for the recovery and resuscitating function of DCD liver grafts. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. [Therapeutic effect of the latest extracorporal elimination procedure (Prometheus treatment) in acute liver failure caused by intoxication].

    Science.gov (United States)

    Bakos, Agnes; Rikker, Csaba; Tóvárosi, Szilveszter; Kárteszi, Mihály

    2007-10-21

    Despite intensive therapy the mortality of acute liver failure without organ transplantation is 60-90%. Because of organ shortage in liver transplantation, a significant number of patients dies while being on the waiting list. In order to diminish the mortality, various trials were introduced to remove the albumin-bound and water-soluble toxins in liver failure with the aim to support the spontaneous regeneration of the liver and maintaining the patients alive until liver transplantation. Prometheus treatment is a relatively new technique combining Fractionated Plasma Separation and Adsorption (FPSA) with a high-flux dialysis. During the procedure the patient's own separated albumin-rich plasma passes through special adsorbents making possible the elimination of albumin-bound toxins, while hemodialysis gets rid of water-soluble toxins. The authors' intention was to demonstrate the efficiency of Prometheus treatment in acute liver failure caused by intoxication. Prometheus treatment was indicated in three patients who suffered from severe intoxication with paracetamol, potassium permanganate and Amanita phalloides, which resulted in a hepatic failure incurable with conservative therapy. Ten treatments were performed in the three female patients. No serious complication was observed. Due to the treatment the albumin-bound (indirect bilirubin p = 0.048; bile acid p = 0.001) and water-soluble (direct bilirubin p = 0.002; creatinine p = 0.007) toxins were significantly decreased. The level of ammonia, urea nitrogen, fibrinogen and antithrombin III did not change significantly. All the three patients were cured without liver transplantation. Prometheus treatment removes efficiently the accumulating toxins in acute liver failure. It is a safe elimination technique. In cases untreatable with conservative therapy it makes possible maintaining the patients alive until the liver regenerates spontaneously, or liver transplantation is feasible.

  1. Olfactomedin-like 3 (OLFML3) gene expression in baboon and human ocular tissues: cornea, lens, uvea and retina

    Science.gov (United States)

    Rodríguez-Sánchez, Iràm Pablo; Garza-Rodríguez, Maria Lourdes; Mohamed-Noriega, Karim; Voruganti, Venkata Saroja; Tejero, Maria Elizabeth; Delgado-Enciso, Ivan; Ibave, Diana Cristina Perez; Schlabritz-Loutsevitch, Natalia E.; Mohamed-Noriega, Jibran; Martinez-Fierro, Margarita L; Reséndez-Pérez, Diana; Cole, Shelley A; Cavazos-Adame, Humberto; Comuzzie, Anthony G.; Mohamed-Hamsho, Jesús; Barrera-Saldaña, Hugo Alberto

    2013-01-01

    Background Olfactomedin-like is a polyfunctional polymeric glycoprotein. This family has at least four members. One member of this family is OLFML3, which is preferentially expressed in placenta but is also detected in other adult tissues including the liver and heart. However, the orthologous rat gene is expressed in the iris, sclera, trabecular meshwork, retina, and optic nerve. Methods OLFML3 amplification was performed by RT-PCR from human and baboon ocular tissues. The products were cloned and sequenced. Results We report OFML3 expression in human and baboon eye. The full CDS has 1221 bp, from which a OFR of 406 amino acid was obtained. The baboon OLFML3 gene nucleotidic sequence has 98%, and amino acidic 99% similarity with humans. Conclusions OLFML3 expression in human and baboon ocular tissues and its high similarity make the baboon a powerful model to deduce the physiological and/or metabolic function of this protein in the eye. PMID:23398349

  2. Metabolism of 17alpha-hydroxyprogesterone caproate by hepatic and placental microsomes of human and baboons.

    Science.gov (United States)

    Yan, Ru; Nanovskaya, Tatiana N; Zharikova, Olga L; Mattison, Donald R; Hankins, Gary D V; Ahmed, Mahmoud S

    2008-05-01

    Recent data from our laboratory revealed the formation of an unknown metabolite of 17 hydroxyprogesterone caproate (17-HPC), used for treatment of preterm deliveries, during its perfusion across the dually perfused human placental lobule. Previously, we demonstrated that the drug is not hydrolyzed, neither in vivo nor in vitro, to progesterone and caproate. Therefore, the hypothesis for this investigation is that 17-HPC is actively metabolized by human and baboon (Papio cynocephalus) hepatic and placental microsomes. Baboon hepatic and placental microsomes were investigated to validate the nonhuman primate as an animal model for drug use during pregnancy. Data presented here indicate that human and baboon hepatic microsomes formed several mono-, di-, and tri-hydroxylated derivatives of 17-HPC. However, microsomes of human and baboon placentas metabolized 17-HPC to its mono-hydroxylated derivatives only in quantities that were a fraction of those formed by their respective livers, except for two metabolites (M16' and M17') that are unique for placenta and contributed to 25% and 75% of the total metabolites formed by human and baboon, respectively. The amounts of metabolites formed, relative to each other, by human and baboon microsomes were different suggesting that the affinity of 17-HPC to CYP enzymes and their activity could be species-dependent.

  3. Extracorporeal Liver Support with Less Fresh Frozen Plasma for Treatment of Acute-on-chronic Liver Failure%少量血浆进行人工肝治疗慢加急性肝衰竭的探讨

    Institute of Scientific and Technical Information of China (English)

    章莉莎; 赵满芝; 许东

    2015-01-01

    目的:观察应用少量血浆进行人工肝治疗慢加急性肝衰竭的疗效。方法回顾性分析45例住院治疗的慢加急性肝衰竭患者,分为观察组(少量血浆PP+ PE组)、对照组1(PE组)、对照组2(PP+PE组)(PP为血浆吸附,PE为血浆置换),共接受人工肝治疗62次。结果3组患者治疗后与治疗前比较,临床症状均有所改善。3组间相比较,在降低谷丙转氨酶(ALT)、谷草转氨酶(AST)、直接胆红素(DBil)这3个指标上差异有统计学意义,对于总胆红素(TBil)的改善和降低血氨等方面无明显差异。在其余肝、肾功能各项指标上3组间差异无统计学意义。与对照组1和对照组2相比,观察组在改善凝血功能方面效果较差,差异有统计学意义。结论在目前血浆紧张的情况下,可以应用血浆吸附联合少量新鲜冰冻血浆进行人工肝治疗,能有效降低胆红素,缓解临床症状,减少并发症的发生。%Objective To observe the efficacy of extracorporeal liver support by using less fresh frozen plasma in the treat‐ment of acute‐on‐chronic liver failure.Methods A total of 45 patients with acute‐on‐chronic liver failure were divided into ob‐servation group[plasma perfusion(PP) with a small amount of plasma+ plasma exchange(PE)] ,control group 1(PE) ,control group 2(PP+PE)in terms of the amount of plasma used on the day of treatment. All the patients received artificial liver treatnts 62 times totally.Results The clinical symptoms were improved in the three groups after treatments.There were significant differences in the decrease of alanine transaminase (ALT) ,aspartate transaminase(AST) and direct bilirubin(DBil)rather than the decrease of total bilirubin(TBil)and blood ammonia among the groups.No significant difference was noted in the liver and kidney function among the three groups. The improvement of the coagulation function was poor in the

  4. Seed size selection by olive baboons.

    Science.gov (United States)

    Kunz, Britta Kerstin; Linsenmair, Karl Eduard

    2008-10-01

    Seed size is an important plant fitness trait that can influence several steps between fruiting and the establishment of a plant's offspring. Seed size varies considerably within many plant species, yet the relevance of the trait for intra-specific fruit choice by primates has received little attention. Primates may select certain seed sizes within a species for a number of reasons, e.g. to decrease indigestible seed load or increase pulp intake per fruit. Olive baboons (Papio anubis, Cercopithecidae) are known to select seed size in unripe and mature pods of Parkia biglobosa (Mimosaceae) differentially, so that pods with small seeds, and an intermediate seed number, contribute most to dispersal by baboons. We tested whether olive baboons likewise select for smaller ripe seeds within each of nine additional fruit species whose fruit pulp baboons commonly consume, and for larger seeds in one species in which baboons feed on the seeds. Species differed in fruit type and seed number per fruit. For five of these species, baboons dispersed seeds that were significantly smaller than seeds extracted manually from randomly collected fresh fruits. In contrast, for three species, baboons swallowed seeds that were significantly longer and/or wider than seeds from fresh fruits. In two species, sizes of ingested seeds and seeds from fresh fruits did not differ significantly. Baboons frequently spat out seeds of Drypetes floribunda (Euphorbiaceae) but not those of other plant species having seeds of equal size. Oral processing of D. floribunda seeds depended on seed size: seeds that were spat out were significantly larger and swallowed seeds smaller, than seeds from randomly collected fresh fruits. We argue that seed size selection in baboons is influenced, among other traits, by the amount of pulp rewarded per fruit relative to seed load, which is likely to vary with fruit and seed shape.

  5. Extracorporeal membrane oxygenation circuitry.

    Science.gov (United States)

    Lequier, Laurance; Horton, Stephen B; McMullan, D Michael; Bartlett, Robert H

    2013-06-01

    The extracorporeal membrane oxygenation circuit is made of a number of components that have been customized to provide adequate tissue oxygen delivery in patients with severe cardiac and/or respiratory failure for a prolonged period of time (days to weeks). A standard extracorporeal membrane oxygenation circuit consists of a mechanical blood pump, gas-exchange device, and a heat exchanger all connected together with circuit tubing. Extracorporeal membrane oxygenation circuits can vary from simple to complex and may include a variety of blood flow and pressure monitors, continuous oxyhemoglobin saturation monitors, circuit access sites, and a bridge connecting the venous access and arterial infusion limbs of the circuit. Significant technical advancements have been made in the equipment available for short- and long-term extracorporeal membrane oxygenation applications. Contemporary extracorporeal membrane oxygenation circuits have greater biocompatibility and allow for more prolonged cardiopulmonary support time while minimizing the procedure-related complications of bleeding, thrombosis, and other physiologic derangements, which were so common with the early application of extracorporeal membrane oxygenation. Modern era extracorporeal membrane oxygenation circuitry and components are simpler, safer, more compact, and can be used across a wide variety of patient sizes from neonates to adults.

  6. Extracorporeal blood purification for acute liver failure in children%血液净化技术在小儿急性肝功能衰竭中的应用

    Institute of Scientific and Technical Information of China (English)

    崔云; 张育才

    2012-01-01

    小儿急性肝功能衰竭病死率高.目前公认的有效治疗方法是肝移植.人工肝为自体肝脏功能恢复创造条件或作为肝脏移植的“桥梁”.人工肝支持系统被分为生物型人工肝装置、非生物型人工肝装置和混合型人工肝装置3类.以往非生物型人工肝应用方法(如血浆置换、血液透析、血液滤过、血液/血浆灌流等)能改善血液生化指标,但不能影响预后.近年来,非生物型人工肝设备有了很大进步,出现了连续性肾替代治疗、组合式血液净化(普罗米修斯系统、分子吸附再循环系统等)新型血液净化模式.新型血液净化模式能提高肝功能衰竭患儿的生存率.%Pediatric acute liver failure has a high mortality.Liver transplantation is the only definite treatment.Extracorporeal liver support can be employed as a strategy for bridging to transplantation or recovery.There are three types of device for temporary support:biological,non-biological (also called artificial) and bio-artificial (hybrid techniques).Early non-biological device including hemodialysis,hemoperfusion/plasma perfusion and plasmapheresis have improved biochemical efficacy,but there are little data for clinical end points.Continuous blood purification and the combination of various non-biological methods such as the molecular adsorbent recirculatory system and Prometheus(R) are new extracorporeal blood purification therapy.The results of many experimental and clinical trials have improved the efficacy of the above mentioned methods.

  7. vaginal histological changes of the baboon

    African Journals Online (AJOL)

    2009-04-04

    Apr 4, 2009 ... baboon is a good model for investigating possible effects of hormonal contraceptives on vaginal epithelium .... folding. The placard and rosette arrangement of cells remained high. .... A randomized, double-blind trial. Mauritas.

  8. The discrimination of baboon grunt calls and human vowel sounds by baboons

    Science.gov (United States)

    Hienz, Robert D.; Jones, April M.; Weerts, Elise M.

    2004-09-01

    The ability of baboons to discriminate changes in the formant structures of a synthetic baboon grunt call and an acoustically similar human vowel (/eh/) was examined to determine how comparable baboons are to humans in discriminating small changes in vowel sounds, and whether or not any species-specific advantage in discriminability might exist when baboons discriminate their own vocalizations. Baboons were trained to press and hold down a lever to produce a pulsed train of a standard sound (e.g., /eh/ or a baboon grunt call), and to release the lever only when a variant of the sound occurred. Synthetic variants of each sound had the same first and third through fifth formants (F1 and F3-5), but varied in the location of the second formant (F2). Thresholds for F2 frequency changes were 55 and 67 Hz for the grunt and vowel stimuli, respectively, and were not statistically different from one another. Baboons discriminated changes in vowel formant structures comparable to those discriminated by humans. No distinct advantages in discrimination performances were observed when the baboons discriminated these synthetic grunt vocalizations.

  9. Epizootic pertussis focus of hamadryad baboons

    Directory of Open Access Journals (Sweden)

    A. Yu. Medkova

    2015-01-01

    Full Text Available The absence of an adequate experimental animal model makes difficult study of immunity against whooping cough and its pathogenesis. Experimental whooping cough reported by us earlier in pubescent non-human primates of the Old World was accompanied by specific clinical and laboratory marks in the absence of cough. The possibility of pertussis modelling while experimental whooping cough in impuberal hamadryad baboons was investigated. In the process of selection of monkeys for the further studies for perfecting of experimental model for pertussis research unexpectedly were detected specific pertussis antibodies in impuberal hamadryad baboons.The aim of the study: revealing of source of infection and transmission of pertussis to hamadryad baboons and investigation of response of antibody-positive impuberal hamadryad baboons to secondary contagion by B. pertussis bacteria while experimental infection.Results. 18 veterinary checked, somatically healthy hamadryad baboons of various gender managed in two neighboring cages. Specific pertussis IgM and IgG antibodies were found in blood serum of all the animals and one of the monkey keepers. By real-time PCR in nasopharyngeal swabs of the monkey keeper and three 7- and 9-month-old hamadryad baboons were registered single B. pertussis genom equivalents. Seropositive impuberal hamadryad baboons were experimentally challenged by virulent B. pertussis 475 strain. Quantity of B. pertussis genom equivalents and percentage of IgM and IgG antibodies in impuberal hamadryad baboons after experimental infection were detected. These results were comparable with such received after secondary experimental challenge of monkeys by B. pertussis. Humoral immuneresponse was characterized by booster effect and rapid B. pertussis elimination.Conclusion. The case of transmission of B.pertussis bacteria to hamadryad baboons by natural contagion and epizootic focus of pertussis in apery conditions

  10. Kinetics of glyburide metabolism by hepatic and placental microsomes of human and baboon.

    Science.gov (United States)

    Zharikova, Olga L; Ravindran, Selvan; Nanovskaya, Tatiana N; Hill, Ronald A; Hankins, Gary D V; Ahmed, Mahmoud S

    2007-06-15

    Glyburide (glibenclamide) is under investigation for treatment of gestational diabetes. Two metabolites of glyburide have been previously identified in patients, namely, 4-trans-(M1) and 3-cis-(M2) hydroxycyclohexyl glyburide. Recently, the metabolism of glyburide by microsomes of liver and placenta from humans and baboons revealed the formation of four additional metabolites: 4-cis-(M2a), 3-trans-(M3), and 2-trans-(M4) hydroxycyclohexyl glyburide, and ethyl-hydroxy glyburide (M5). The aim of this investigation was to determine the kinetics for the metabolism of glyburide by cytochrome P450 (CYP) isozymes of human and baboon placental and hepatic microsomes. The metabolism of glyburide by microsomes from the four organs revealed saturation kinetics and apparent K(m) values between 4 and 12 microM. However, the rates for formation of the metabolites varied between organs and species. M1 was the major metabolite (36% of total), formed by human hepatic microsomes with V(max) of 80+/-13 pmol mg protein(-1)min(-1), and together with M2, accounted for only 51% of the total. M5 was the major metabolite (87%) formed by human placental microsomes with V(max) of 11 pmol mg protein(-1)min(-1). In baboon liver, M5 had the highest rate of formation (V(max) 135+/-32 pmol mg protein(-1)min(-1), 39% of total), and in its placenta, was M4 (V(max) 0.7+/-0.1 pmol mg protein(-1)min(-1), 65%). The activity of human and baboon hepatic microsomes in metabolizing glyburide was similar, but the activity of human and baboon placental microsomes was 7% and 0.3% of their respective hepatic microsomes. The data obtained suggest that more than 1 CYP isozyme is responsible for catalyzing the hydroxylation of glyburide.

  11. Extra-corporeal membrane oxygenation

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/007234.htm Extracorporeal membrane oxygenation To use the sharing features on this page, please enable JavaScript. Extracorporeal membrane oxygenation (ECMO) is a treatment that uses a ...

  12. Extracorporeal treatment for thallium poisoning

    DEFF Research Database (Denmark)

    Ghannoum, Marc; Nolin, Thomas D; Goldfarb, David S

    2012-01-01

    The EXtracorporeal TReatments In Poisoning (EXTRIP) workgroup was formed to provide recommendations on the use of extracorporeal treatment (ECTR) in poisoning. To test and validate its methods, the workgroup reviewed data for thallium (Tl).......The EXtracorporeal TReatments In Poisoning (EXTRIP) workgroup was formed to provide recommendations on the use of extracorporeal treatment (ECTR) in poisoning. To test and validate its methods, the workgroup reviewed data for thallium (Tl)....

  13. Bioartificial liver: current status.

    Science.gov (United States)

    Pless, G; Sauer, I M

    2005-11-01

    Liver failure remains a life-threatening syndrome. With the growing disparity between the number of suitable donor organs and the number of patients awaiting transplantation, efforts have been made to optimize the allocation of organs, to find alternatives to cadaveric liver transplantation, and to develop extracorporeal methods to support or replace the function of the failing organ. An extracorporeal liver support system has to provide the main functions of the liver: detoxification, synthesis, and regulation. The understanding that the critical issue of the clinical syndrome in liver failure is the accumulation of toxins not cleared by the failing liver led to the development of artificial filtration and adsorption devices (artificial liver support). Based on this hypothesis, the removal of lipophilic, albumin-bound substances, such as bilirubin, bile acids, metabolites of aromatic amino acids, medium-chain fatty acids, and cytokines, should be beneficial to the clinical course of a patient in liver failure. Artificial detoxification devices currently under clinical evaluation include the Molecular Adsorbent Recirculating System (MARS), Single-Pass Albumin Dialysis (SPAD), and the Prometheus system. The complex tasks of regulation and synthesis remain to be addressed by the use of liver cells (bioartificial liver support). The Extracorporeal Liver Assist Device (ELAD), HepatAssist, Modular Extracorporeal Liver Support system (MELS), and the Amsterdam Medical Center Bioartificial Liver (AMC-BAL) are bioartificial systems. This article gives a brief overview on these artificial and bioartificial devices and discusses remaining obstacles.

  14. Pathogenetic substantiation of extracorporeal detoxication in surgery.

    Science.gov (United States)

    Ender, L A; Lekhtman, A M; Lobakov, A I

    1990-01-01

    The report is based on the results of treatment of 116 patients with severe purulent-destructive abdominal cavity diseases and 320 patients with liver failure due to bile ducts obturation. Along with surgical operations, methods of organism extracorporeal detoxication-haemosorption, exchange plasmapheresis, autoblood ultraviolet irradiation--were used in all patients either in isolation or in combination with each other. Toxical metabolites concentration, blood integral toxicity, peptids with mean molecular weight concentration, liver profile enzimes activity, lipid metabolism indices, general and liver haemodynamics and electroencephalogram were studied. On the basis of correlations between indices obtained by the method of extreme grouping factors-syndromes were formed, and then in accordance with a special program summary evaluation of detoxication was calculated in marks. A drop in lethality by 28.3% was ensured, as well as a drop in postoperatyonal liver failure by 51.4%.

  15. Extracorporeal Treatment for Lithium Poisoning

    DEFF Research Database (Denmark)

    Decker, Brian S; Goldfarb, David S; Dargan, Paul I

    2015-01-01

    The Extracorporeal Treatments in Poisoning Workgroup was created to provide evidence-based recommendations on the use of extracorporeal treatments in poisoning. Here, the EXTRIP workgroup presents its recommendations for lithium poisoning. After a systematic literature search, clinical and toxico......The Extracorporeal Treatments in Poisoning Workgroup was created to provide evidence-based recommendations on the use of extracorporeal treatments in poisoning. Here, the EXTRIP workgroup presents its recommendations for lithium poisoning. After a systematic literature search, clinical...... extraction of patient-level data. The workgroup concluded that lithium is dialyzable (Level of evidence=A) and made the following recommendations: Extracorporeal treatment is recommended in severe lithium poisoning (1D). Extracorporeal treatment is recommended if kidney function is impaired and the [Li...... treatment (1D), but continuous RRT is an acceptable alternative (1D). The workgroup supported the use of extracorporeal treatment in severe lithium poisoning. Clinical decisions on when to use extracorporeal treatment should take into account the [Li(+)], kidney function, pattern of lithium toxicity...

  16. Deep learning of orthographic representations in baboons.

    Science.gov (United States)

    Hannagan, Thomas; Ziegler, Johannes C; Dufau, Stéphane; Fagot, Joël; Grainger, Jonathan

    2014-01-01

    What is the origin of our ability to learn orthographic knowledge? We use deep convolutional networks to emulate the primate's ventral visual stream and explore the recent finding that baboons can be trained to discriminate English words from nonwords. The networks were exposed to the exact same sequence of stimuli and reinforcement signals as the baboons in the experiment, and learned to map real visual inputs (pixels) of letter strings onto binary word/nonword responses. We show that the networks' highest levels of representations were indeed sensitive to letter combinations as postulated in our previous research. The model also captured the key empirical findings, such as generalization to novel words, along with some intriguing inter-individual differences. The present work shows the merits of deep learning networks that can simulate the whole processing chain all the way from the visual input to the response while allowing researchers to analyze the complex representations that emerge during the learning process.

  17. Extra-corporeal liver BNCT for the treatment of diffuse metastases: what was learned and what is still to be learned.

    Science.gov (United States)

    Zonta, A; Pinelli, T; Prati, U; Roveda, L; Ferrari, C; Clerici, A M; Zonta, C; Mazzini, G; Dionigi, P; Altieri, S; Bortolussi, S; Bruschi, P; Fossati, F

    2009-07-01

    Almost eight years ago, in December 2001, we performed for the first time in the world thermal neutron irradiation on an isolated liver of a patient. The organ was affected by diffuse metastases of a colon carcinoma and had been previously loaded with a (10)B compound. In July 2003, the same procedure was applied again on a patient for the treatment of unresectable and incurable hepatic metastases of a carcinoma of the rectum. Both patients are dead at present. Now we can analyze in depth the clinical history of these patients and evaluate the effectiveness of this therapy. From this exciting experience we learned much, and we also found out about complications till then unknown, which need to be studied and addressed experimentally. Unfortunately we can base our conclusions just on the experience we had with these two patients. We could have been much more detailed and firm in our statements if the number of clinical cases was larger. The BNCT Pavia project has been suspended, but it is more than likely to resume in a short time. Good findings were many. The procedure is feasible; the original concept of complete immersion of the diseased liver in a homogeneous neutron field proved effective and winning. The tumor masses resulted completely necrotic and unknown metastases too appeared radically treated; healthy hepatic tissue was preserved from both morphological and functional points of view; no symptoms of cirrhosis appeared even four years after treatment. For the long term surviving patient, quality of life was excellent. Other findings require to be tackled in depth. The "post-irradiation syndrome" we observed in both patients, with identical symptoms and biochemical derangements, creates a dramatic--even though totally reversible--clinical condition, that is the probable cause of death for our second patient, suffering from cardiomyopathy, 33 days after treatment. For the first patient, recurrences were a late yet fatal complication, for which even a further

  18. Extracorporeal Treatment for Metformin Poisoning

    DEFF Research Database (Denmark)

    Calello, Diane P; Liu, Kathleen D; Wiegand, Timothy J

    2015-01-01

    BACKGROUND: Metformin toxicity, a challenging clinical entity, is associated with a mortality of 30%. The role of extracorporeal treatments such as hemodialysis is poorly defined at present. Here, the Extracorporeal Treatments In Poisoning workgroup, comprising international experts representing...... diverse professions, presents its systematic review and clinical recommendations for extracorporeal treatment in metformin poisoning. METHODS: A systematic literature search was performed, data extracted, findings summarized, and structured voting statements developed. A two-round modified Delphi method......) and made the following recommendations: extracorporeal treatment is recommended in severe metformin poisoning (1D). Indications for extracorporeal treatment include lactate concentration greater than 20 mmol/L (1D), pH less than or equal to 7.0 (1D), shock (1D), failure of standard supportive measures (1D...

  19. Extracorporeal Treatment for Salicylate Poisoning

    DEFF Research Database (Denmark)

    Juurlink, David N; Gosselin, Sophie; Kielstein, Jan T

    2015-01-01

    STUDY OBJECTIVE: Salicylate poisoning is a challenging clinical entity associated with substantial morbidity and mortality. The indications for extracorporeal treatments such as hemodialysis are poorly defined. We present a systematic review of the literature along with evidence- and consensus......-based recommendations on the use of extracorporeal treatment in salicylate poisoning. METHODS: The Extracorporeal Treatments in Poisoning (EXTRIP) Workgroup is a multidisciplinary group with international representation whose aim is to provide evidence-based recommendations on the use of extracorporeal treatments...... in poisoning. We conducted a systematic literature review followed by data extraction and summarized findings, following a predetermined format. The entire work group voted by a 2-round modified Delphi method to reach consensus on voting statements, using a RAND/UCLA Appropriateness Method to quantify...

  20. Taxonomy Icon Data: hamadryas baboon [Taxonomy Icon

    Lifescience Database Archive (English)

    Full Text Available hamadryas baboon Papio hamadryas Chordata/Vertebrata/Mammalia/Theria/Eutheria/Primate Papio_hamadry...as_L.png Papio_hamadryas_NL.png Papio_hamadryas_S.png Papio_hamadryas_NS.png http://bioscien...cedbc.jp/taxonomy_icon/icon.cgi?i=Papio+hamadryas&t=L http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Papio+hamadry...as&t=NL http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Papio+hamadryas&...t=S http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Papio+hamadryas&t=NS http://togodb.biosciencedbc.jp/togodb/view/taxonomy_icon_comment_en?species_id=186 ...

  1. Renal histopathology of a baboon model with type 2 diabetes.

    Science.gov (United States)

    Rincon-Choles, Hernan; Abboud, Hanna E; Lee, Shuko; Shade, Robert E; Rice, Karen S; Carey, K Dee; Comuzzie, Anthony G; Barnes, Jeffrey L

    2012-10-01

    Naturally occurring type 2 diabetes has been found in a colony of baboons. Ongoing characterization of the baboon colony maintained at the Southwest National Primate Research Center has revealed a significant range of glucose sensitivity with some animals clearly diabetic.   Seven baboons, four with diabetes and three without diabetes, underwent histopathological investigation. Three diabetic animals were diagnosed using fasting blood glucose, hemoglobin A1C, and intravenous glucose tolerance test, and a fourth one was known to have hyperglycemia. One control baboon and three baboons with diabetes had microalbuminuria. On kidney biopsy, diabetic baboons had thickening of the glomerular basement membrane and mesangial matrix expansion compared to controls. Immunohistochemistry showed the diabetic animals had increased mesangial expression of cellular fibronectin ED-A. Two diabetic animals with microalbuminuria had evidence of mesangiolysis with the formation of an early nodule. One diabetic animal had a Kimmestiel-Wilson nodule. We conclude that the baboon represents a useful primate model of diabetes and nephropathy that resembles the nephropathy associated with type 2 diabetes in humans.

  2. The history of extracorporeal oxygenators.

    Science.gov (United States)

    Lim, M W

    2006-10-01

    Extracorporeal oxygenators are artificial devices that substitute for anatomical lungs by delivering oxygen to, and extracting carbon dioxide from, blood. They were first conceptualised by the English scientist Robert Hooke (1635-1703) and developed into practical extracorporeal oxygenators by French and German experimental physiologists in the 19th century. Indeed, most of the extracorporeal oxygenators used until the late 1970s were derived from von Schroder's 1882 bubble oxygenator and Frey and Gruber's 1885 film oxygenator. As there is no intervening barrier between blood and oxygen, these are called 'direct contact' oxygenators; they contributed significantly to the development and practice of cardiac surgery till the 1980s. Membrane extracorporeal oxygenators introduce a gas-permeable interface between blood and oxygen. This greatly decreased the blood trauma of direct-contact extracorporeal oxygenators, and enabled extracorporeal oxygenators to be used in longer-term applications such as the intensive therapy of respiratory distress syndrome; this was demonstrably beneficial for neonates but less so for older patients. Much work since the 1960s focused on overcoming the gas exchange handicap of the membrane barrier, leading to the development of high-performance microporous hollow-fibre oxygenators that eventually replaced direct-contact oxygenators in cardiac theatres.

  3. Extracorporeal cardiopulmonary resuscitation

    Directory of Open Access Journals (Sweden)

    Steven A. Conrad

    2016-04-01

    Full Text Available ECPR is defined as the rapidly-deployed application of venoarterial extracorporeal membrane oxygenation, in patients with cardiac arrest, during cardiopulmonary resuscitation before the return of ROSC. ECPR is one of the most rapidly growing segments of ECLS, and is becoming more widespread. Consideration for institution of ECPR is given to patients with witnessed arrest, good quality CPR instituted within 5 min of arrest, in whom ROSC does not occur within 15 min, and who can complete cannulation within 30–60 min. Patients from both inpatient and out-of-hospital settings are candidates if they meet these criteria. Deep hypothermic cardiac arrest, such as cold-water drowning, should receive consideration for ECPR even after considerable duration of arrest. Available outcome data are based on retrospective observation studies, some with propensity matching, and suggests a higher chance for survival with ECPR. Published outcomes from ECPR, however, are difficult to interpret, since many centers classify their use of ECLS after ROSC, in addition to ECLS before ROSC, as ECPR. Both children and adults are candidates for ECPR, but the experience in children is weighted heavily toward those with a diagnosis of cardiac disease and arrest occurring within closely monitored units.

  4. Extracorporeal treatment for acetaminophen poisoning

    DEFF Research Database (Denmark)

    Gosselin, S; Juurlink, D N; Kielstein, J T

    2014-01-01

    BACKGROUND: The Extracorporeal Treatments in Poisoning (EXTRIP) workgroup was created to provide evidence-based recommendations on the use of extracorporeal treatments (ECTR) in poisoning and the results are presented here for acetaminophen (APAP). METHODS: After a systematic review...... cases of APAP poisoning. However, given that APAP is dialyzable, the workgroup agreed that ECTR is suggested in patients with excessively large overdoses who display features of mitochondrial dysfunction. This is reflected by early development of altered mental status and severe metabolic acidosis prior...... and an APAP concentration over 900 mg/L (5960 mmol/L) if NAC is administered (1D). Intermittent hemodialysis (HD) is the preferred ECTR modality in APAP poisoning (1D). CONCLUSION: APAP is amenable to extracorporeal removal. Due to the efficacy of NAC, ECTR is reserved for rare situations when the efficacy...

  5. [Grooming and group structure in hamadryas baboons].

    Science.gov (United States)

    2010-09-01

    The results of 3-year observation on coral living hamadryas baboons transported from natural habitat in Tuapse reservation have been presented. Despite of the fact that grooming between males and females accounted for 73% of total cases of grooming in adult individual pairs, only the relationships of males with high-ranked females of their harems fully corresponded to a star-shaped sociogram. The high-ranked females were not different from all the other females either according to a total number of grooming cases with their female partners or according to a proportion of a performed and received grooming. Grooming between the related females was noted predominantly in the cases when they belonged to the same harem. Grooming between the related males accounted for 59% of all the cases of grooming between the male partners.

  6. A Neutrophil Phenotype Model for Extracorporeal Treatment of Sepsis.

    Directory of Open Access Journals (Sweden)

    Alexander D Malkin

    2015-10-01

    Full Text Available Neutrophils play a central role in eliminating bacterial pathogens, but may also contribute to end-organ damage in sepsis. Interleukin-8 (IL-8, a key modulator of neutrophil function, signals through neutrophil specific surface receptors CXCR-1 and CXCR-2. In this study a mechanistic computational model was used to evaluate and deploy an extracorporeal sepsis treatment which modulates CXCR-1/2 levels. First, a simplified mechanistic computational model of IL-8 mediated activation of CXCR-1/2 receptors was developed, containing 16 ODEs and 43 parameters. Receptor level dynamics and systemic parameters were coupled with multiple neutrophil phenotypes to generate dynamic populations of activated neutrophils which reduce pathogen load, and/or primed neutrophils which cause adverse tissue damage when misdirected. The mathematical model was calibrated using experimental data from baboons administered a two-hour infusion of E coli and followed for a maximum of 28 days. Ensembles of parameters were generated using a Bayesian parallel tempering approach to produce model fits that could recreate experimental outcomes. Stepwise logistic regression identified seven model parameters as key determinants of mortality. Sensitivity analysis showed that parameters controlling the level of killer cell neutrophils affected the overall systemic damage of individuals. To evaluate rescue strategies and provide probabilistic predictions of their impact on mortality, time of onset, duration, and capture efficacy of an extracorporeal device that modulated neutrophil phenotype were explored. Our findings suggest that interventions aiming to modulate phenotypic composition are time sensitive. When introduced between 3-6 hours of infection for a 72 hour duration, the survivor population increased from 31% to 40-80%. Treatment efficacy quickly diminishes if not introduced within 15 hours of infection. Significant harm is possible with treatment durations ranging from 5

  7. Extracorporeal treatment for digoxin poisoning

    DEFF Research Database (Denmark)

    Mowry, James B; Burdmann, Emmanuel A; Anseeuw, Kurt

    2016-01-01

    BACKGROUND: The Extracorporeal Treatments in Poisoning (EXTRIP) workgroup was formed to provide recommendations on the use of extracorporeal treatments (ECTR) in poisoning. Here, we present our results for digoxin. METHODS: After a systematic literature search, clinical and toxicokinetic data were...... recommended against the use of ECTR in cases of severe digoxin poisoning when Fab was available (1D) and also suggested against the use of ECTR when Fab was unavailable (2D). CONCLUSION: ECTR, in any form, is not indicated for either suspected or proven digoxin toxicity, regardless of the clinical context...

  8. Charting the neglected West: The social system of Guinea baboons.

    Science.gov (United States)

    Fischer, Julia; Kopp, Gisela H; Dal Pesco, Federica; Goffe, Adeelia; Hammerschmidt, Kurt; Kalbitzer, Urs; Klapproth, Matthias; Maciej, Peter; Ndao, Ibrahima; Patzelt, Annika; Zinner, Dietmar

    2017-01-01

    Primate social systems are remarkably diverse, and thus play a central role in understanding social evolution, including the biological origin of human societies. Although baboons have been prominently featured in this context, historically little was known about the westernmost member of the genus, the Guinea baboon (Papio papio). Here, we summarize the findings from the first years of observations at the field site CRP Simenti in the Niokolo Koba National Park in Senegal. Guinea baboons reveal a nested multi-level social organization, with reproductive units comprising one "primary" male, one to several females, young, and occasionally "secondary" males at the base of the society. Three to five units form "parties," which team up with other parties to form a "gang." Different gangs have largely overlapping home ranges and agonistic interactions between different parties or gangs are rare. Some but not all strongly socially bonded males are highly related, and population genetic and behavioral evidence indicate female-biased dispersal. Females play an important role in intersexual bond formation and maintenance, and female tenure length varies between a few weeks to several years. While the social organization resembles that of hamadryas baboons (P. hamadryas), the social structure differs considerably, specifically in terms of low male aggressiveness and female freedom. Despite substantial differences in social organization and social structure, the acoustic structure of Guinea baboon vocalizations does not differ substantially from that of other baboon taxa. With its multi-level organization, stable bonds between males and females, as well as a high-degree of male-male cooperation and tolerance, Guinea baboons constitute an intriguing model for reconstructing human social evolution. © 2017 American Association of Physical Anthropologists.

  9. Quantitation of fibroblast activation protein (FAP-specific protease activity in mouse, baboon and human fluids and organs

    Directory of Open Access Journals (Sweden)

    Fiona M. Keane

    2014-01-01

    Full Text Available The protease fibroblast activation protein (FAP is a specific marker of activated mesenchymal cells in tumour stroma and fibrotic liver. A specific, reliable FAP enzyme assay has been lacking. FAP's unique and restricted cleavage of the post proline bond was exploited to generate a new specific substrate to quantify FAP enzyme activity. This sensitive assay detected no FAP activity in any tissue or fluid of FAP gene knockout mice, thus confirming assay specificity. Circulating FAP activity was ∼20- and 1.3-fold less in baboon than in mouse and human plasma, respectively. Serum and plasma contained comparable FAP activity. In mice, the highest levels of FAP activity were in uterus, pancreas, submaxillary gland and skin, whereas the lowest levels were in brain, prostate, leukocytes and testis. Baboon organs high in FAP activity included skin, epididymis, bladder, colon, adipose tissue, nerve and tongue. FAP activity was greatly elevated in tumours and associated lymph nodes and in fungal-infected skin of unhealthy baboons. FAP activity was 14- to 18-fold greater in cirrhotic than in non-diseased human liver, and circulating FAP activity was almost doubled in alcoholic cirrhosis. Parallel DPP4 measurements concorded with the literature, except for the novel finding of high DPP4 activity in bile. The new FAP enzyme assay is the first to be thoroughly characterised and shows that FAP activity is measurable in most organs and at high levels in some. This new assay is a robust tool for specific quantitation of FAP enzyme activity in both preclinical and clinical samples, particularly liver fibrosis.

  10. What baboons can (not) tell us about natural language grammars.

    Science.gov (United States)

    Poletiek, Fenna H; Fitz, Hartmut; Bocanegra, Bruno R

    2016-06-01

    Rey et al. (2012) present data from a study with baboons that they interpret in support of the idea that center-embedded structures in human language have their origin in low level memory mechanisms and associative learning. Critically, the authors claim that the baboons showed a behavioral preference that is consistent with center-embedded sequences over other types of sequences. We argue that the baboons' response patterns suggest that two mechanisms are involved: first, they can be trained to associate a particular response with a particular stimulus, and, second, when faced with two conditioned stimuli in a row, they respond to the most recent one first, copying behavior they had been rewarded for during training. Although Rey et al. (2012) 'experiment shows that the baboons' behavior is driven by low level mechanisms, it is not clear how the animal behavior reported, bears on the phenomenon of Center Embedded structures in human syntax. Hence, (1) natural language syntax may indeed have been shaped by low level mechanisms, and (2) the baboons' behavior is driven by low level stimulus response learning, as Rey et al. propose. But is the second evidence for the first? We will discuss in what ways this study can and cannot give evidential value for explaining the origin of Center Embedded recursion in human grammar. More generally, their study provokes an interesting reflection on the use of animal studies in order to understand features of the human linguistic system. Copyright © 2015 Elsevier B.V. All rights reserved.

  11. The baboon kidney transcriptome: analysis of transcript sequence, splice variants, and abundance.

    Directory of Open Access Journals (Sweden)

    Kimberly D Spradling

    Full Text Available The baboon is an invaluable model for the study of human health and disease, including many complex diseases of the kidney. Although scientists have made great progress in developing this animal as a model for numerous areas of biomedical research, genomic resources for the baboon, such as a quality annotated genome, are still lacking. To this end, we characterized the baboon kidney transcriptome using high-throughput cDNA sequencing (RNA-Seq to identify genes, gene variants, single nucleotide polymorphisms (SNPs, insertion-deletion polymorphisms (InDels, cellular functions, and key pathways in the baboon kidney to provide a genomic resource for the baboon. Analysis of our sequencing data revealed 45,499 high-confidence SNPs and 29,813 InDels comparing baboon cDNA sequences with the human hg18 reference assembly and identified 35,900 cDNAs in the baboon kidney, including 35,150 transcripts representing 15,369 genic genes that are novel for the baboon. Gene ontology analysis of our sequencing dataset also identified numerous biological functions and canonical pathways that were significant in the baboon kidney, including a large number of metabolic pathways that support known functions of the kidney. The results presented in this study catalogues the transcribed mRNAs, noncoding RNAs, and hypothetical proteins in the baboon kidney and establishes a genomic resource for scientists using the baboon as an experimental model.

  12. The Baboon (Papio spp. as a Model of Human Ebola Virus Infection

    Directory of Open Access Journals (Sweden)

    Gary L.White

    2012-10-01

    Full Text Available Baboons are susceptible to natural Ebola virus (EBOV infection and share 96% genetic homology with humans. Despite these characteristics, baboons have rarely been utilized as experimental models of human EBOV infection to evaluate the efficacy of prophylactics and therapeutics in the United States. This review will summarize what is known about the pathogenesis of EBOV infection in baboons compared to EBOV infection in humans and other Old World nonhuman primates. In addition, we will discuss how closely the baboon model recapitulates human EBOV infection. We will also review some of the housing requirements and behavioral attributes of baboons compared to other Old World nonhuman primates. Due to the lack of data available on the pathogenesis of Marburg virus (MARV infection in baboons, discussion of the pathogenesis of MARV infection in baboons will be limited.

  13. Immunological compatibility between the chacma baboon and man.

    Science.gov (United States)

    Stark, J H; Smit, J A; Neethling, F A; Nortman, P J; Myburgh, J A

    1991-12-01

    Predictions of an increasing shortage of donor organs for the future has led to a resurgence of interest in xenotransplantation. We have methodically assessed the immunological compatibility of humans against the chacma baboon with a view to narrowing the gap of concordance by careful immunological screening. The necessity of major blood group compatibility in xenotransplantation is now established. While no group O universal donor exists in the baboon, groups A (45%), B (15%), and AB (40%) are well represented. Baboon histocompatibility antigens could not be precisely defined using human antisera. This does not necessarily imply lack of homology between the species, as we have shown specific crossreactivity of numerous antihuman monoclonal antibodies with baboon leukocytes. Normal humans do not exhibit preformed agglutinins to erythrocytes of the chacma baboon (Papio ursinus orientalis)) but cytotoxic antibodies are occasionally found. Sera from allosensitized patients may contain crossreacting hemagglutinins, leukoagglutinins and complement-dependent cytotoxic antibodies. Binding of human immunoglobulin-G and -M to baboon targets was demonstrated by flow cytometry. Negative crossmatch combinations for antibodies of the IgG subclass were easily found, but IgM antibodies from allosensitized patients were polyspecific in their action. In vitro assessment of lymphocyte mediated cytotoxicity showed that preformed cellular immunity between the species was rare. The response of human lymphocytes to xenoantigen stimulation in mixed lymphocyte cultures showed a normal distribution, permitting the selection of low-responding combinations. Screening for viruses, especially HTLV-1 and Coxsackie-BL34, is important. These findings demonstrate a closer degree of concordance than has previously been suspected.

  14. Metabolism of bupropion by baboon hepatic and placental microsomes

    OpenAIRE

    2011-01-01

    The aim of this investigation was to determine the biotransformation of bupropion by baboon hepatic and placental microsomes, identify the enzyme(s) catalyzing the reaction(s) and determine its kinetics. Bupropion was metabolized by baboon hepatic and placental microsomes to hydroxybupropion (OH-BUP), threo- (TB) and erythrohydrobupropion (EB). OH-bupropion was the major metabolite formed by hepatic microsomes (Km 36 ± 6 µM, Vmax 258 ± 32 pmol mg protein−1 min−1), however the formation of OH-...

  15. Extracorporeal treatment for theophylline poisoning

    DEFF Research Database (Denmark)

    Ghannoum, Marc; Wiegand, Timothy J; Liu, Kathleen D

    2015-01-01

    BACKGROUND: The Extracorporeal Treatments in Poisoning workgroup was created to provide evidence-based recommendations on the use of extracorporeal treatments (ECTRs) in poisoning. Here, the workgroup presents its systematic review and recommendations for theophylline. METHODS: After a systematic...... theophylline poisoning (1C). Specific recommendations for ECTR include a theophylline concentration [theophylline] > 100 mg/L (555 μmol/L) in acute exposure (1C), the presence of seizures (1D), life-threatening dysrhythmias (1D) or shock (1D), a rising [theophylline] despite optimal therapy (1D), and clinical...... deterioration despite optimal care (1D). In chronic poisoning, ECTR is suggested if [theophylline] > 60 mg/L (333 μmol/L) (2D) or if the [theophylline] > 50 mg/L (278 μmol/L) and the patient is either less than 6 months of age or older than 60 years of age (2D). ECTR is also suggested if gastrointestinal...

  16. Extracorporeal treatment for barbiturate poisoning

    DEFF Research Database (Denmark)

    Mactier, Robert; Laliberté, Martin; Mardini, Joelle

    2014-01-01

    The EXTRIP (Extracorporeal Treatments in Poisoning) Workgroup conducted a systematic review of barbiturate poisoning using a standardized evidence-based process to provide recommendations on the use of extracorporeal treatment (ECTR) in patients with barbiturate poisoning. The authors reviewed all......-acting barbiturates are dialyzable and short-acting barbiturates are moderately dialyzable. Four key recommendations were made. (1) The use of ECTR should be restricted to cases of severe long-acting barbiturate poisoning. (2) The indications for ECTR in this setting are the presence of prolonged coma, respiratory...... treatment should be continued during ECTR. (4) Cessation of ECTR is indicated when clinical improvement is apparent. This report provides detailed descriptions of the rationale for all recommendations. In summary, patients with long-acting barbiturate poisoning should be treated with ECTR provided at least...

  17. Extracorporeal Treatment in Phenytoin Poisoning

    DEFF Research Database (Denmark)

    Anseeuw, Kurt; Mowry, James B; Burdmann, Emmanuel A

    2016-01-01

    The Extracorporeal Treatments in Poisoning (EXTRIP) Workgroup conducted a systematic literature review using a standardized process to develop evidence-based recommendations on the use of extracorporeal treatment (ECTR) in patients with phenytoin poisoning. The authors reviewed all articles......) despite its high protein binding and made the following recommendations. ECTR would be reasonable in select cases of severe phenytoin poisoning (neutral recommendation, 3D). ECTR is suggested if prolonged coma is present or expected (graded 2D) and it would be reasonable if prolonged incapacitating ataxia...... is present or expected (graded 3D). If ECTR is used, it should be discontinued when clinical improvement is apparent (graded 1D). The preferred ECTR modality in phenytoin poisoning is intermittent hemodialysis (graded 1D), but hemoperfusion is an acceptable alternative if hemodialysis is not available...

  18. Extracorporeal treatment for carbamazepine poisoning

    DEFF Research Database (Denmark)

    Ghannoum, Marc; Yates, Christopher; Galvao, Tais F

    2014-01-01

    CONTEXT: The Extracorporeal Treatments in Poisoning (EXTRIP) workgroup was created to provide evidence and consensus-based recommendations on the use of extracorporeal treatments (ECTRs) in poisoning. OBJECTIVES: To perform a systematic review and provide clinical recommendations for ECTR...... in carbamazepine poisoning. METHODS: After a systematic literature search, the subgroup extracted the data and summarized the findings following a pre-determined format. The entire workgroup voted via a two-round modified Delphi method to reach a consensus on voting statements, using a RAND/UCLA Appropriateness...... is suggested in severe carbamazepine poisoning (2D). ECTR is recommended if multiple seizures occur and are refractory to treatment (1D), or if life-threatening dysrhythmias occur (1D). ECTR is suggested if prolonged coma or respiratory depression requiring mechanical ventilation are present (2D...

  19. Hospital Costs Of Extracorporeal Life Support Therapy

    NARCIS (Netherlands)

    Oude Lansink-Hartgring, Annemieke; van den Hengel, Berber; van der Bij, Wim; Erasmus, Michiel E.; Mariani, Massimo A.; Rienstra, Michiel; Cernak, Vladimir; Vermeulen, Karin M.; van den Bergh, Walter M.

    2016-01-01

    Objectives: To conduct an exploration of the hospital costs of extracorporeal life support therapy. Extracorporeal life support seems an efficient therapy for acute, potentially reversible cardiac or respiratory failure, when conventional therapy has been inadequate, or as bridge to transplant, but

  20. Increased lymphoid tissue apoptosis in baboons with bacteremic shock.

    Science.gov (United States)

    Efron, Philip A; Tinsley, Kevin; Minnich, Douglas J; Monterroso, Victor; Wagner, J; Lainée, Pierre; Lorré, Katrien; Swanson, Paul E; Hotchkiss, Richard; Moldawer, Lyle L

    2004-06-01

    The molecular mechanisms of immune cell apoptosis during sepsis remain unclear. Two young adult baboons (Papio sp.) received a lethal dose of live Escherichia coli and were sacrificed at either 16 (for animal welfare concerns) or 24 h post-septic shock. An additional baboon, which received no bacteria, served as a control. Necropsy was performed immediately with subsequent immunohistochemical staining of lymphoid tissue. Immunohistologic analysis of tissues from the septic baboons revealed marked systemic lymphocyte apoptosis occurring in all lymphoid tissues examined. Focally, pyknotic and karyorrhectic lymphocytes demonstrated activation of a mitochondrial-dependent cell death pathway (active caspase 9 and apoptosis-inducing factor). Other regions demonstrated apoptotic lymphocytes with activation of a death receptor-dependent cell pathway (Fas ligand). Thus, we have demonstrated for the first time in primates that overwhelming gram-negative bacteremia produces an early and profound lymphocyte death that occurs through multiple cell death pathways. Bacteremic shock in the baboon may be an appropriate model for studying experimental therapies aimed at blocking lymphocyte apoptosis because their response appears comparable to humans dying from sepsis.

  1. Metabolism of bupropion by baboon hepatic and placental microsomes.

    Science.gov (United States)

    Wang, Xiaoming; Abdelrahman, Doaa R; Fokina, Valentina M; Hankins, Gary D V; Ahmed, Mahmoud S; Nanovskaya, Tatiana N

    2011-08-01

    The aim of this investigation was to determine the biotransformation of bupropion by baboon hepatic and placental microsomes, identify the enzyme(s) catalyzing the reaction(s) and determine its kinetics. Bupropion was metabolized by baboon hepatic and placental microsomes to hydroxybupropion (OH-BUP), threo- (TB) and erythrohydrobupropion (EB). OH-bupropion was the major metabolite formed by hepatic microsomes (Km 36±6 μM, Vmax 258±32 pmol mg protein(-1) min(-1)), however the formation of OH-BUP by placental microsomes was below the limit of quantification. The apparent Km values of bupropion for the formation of TB and EB by hepatic and placental microsomes were similar. The selective inhibitors of CYP2B6 (ticlopidine and phencyclidine) and monoclonal antibodies raised against human CYP2B6 isozyme caused 80% inhibition of OH-BUP formation by baboon hepatic microsomes. The chemical inhibitors of aldo-keto reductases (flufenamic acid), carbonyl reductases (menadione), and 11β-hydroxysteroid dehydrogenases (18β-glycyrrhetinic acid) significantly decreased the formation of TB and EB by hepatic and placental microsomes. Data indicate that CYP2B of baboon hepatic microsomes is responsible for biotransformation of bupropion to OH-BUP, while hepatic and placental short chain dehydrogenases/reductases and to a lesser extent aldo-keto reductases are responsible for the reduction of bupropion to TB and EB.

  2. Inherently analog quantity representations in olive baboons (Papio anubis

    Directory of Open Access Journals (Sweden)

    Allison M Barnard

    2013-05-01

    Full Text Available Strong evidence indicates that non-human primates possess a numerical representation system, but the inherent nature of that system is still debated. Two cognitive mechanisms have been proposed to account for non-human primate numerical performance: (1 a discrete object-file system limited to quantities <4, and (2 an analog system which represents quantities comparatively but is limited by the ratio between two quantities. To test the underlying nature of non-human primate quantification, we asked eight experiment -naive olive baboons (Papio anubis to discriminate between number pairs containing small (<4, large (>4, or span (small vs. large numbers of food items presented simultaneously or sequentially. The prediction from the object-file hypothesis is that baboons will only accurately choose the larger quantity in small pairs, but not large or span pairs. Conversely, the analog system predicts that baboons will be successful with all numbers, and that success will be dependent on numerical ratio. We found that baboons successfully discriminated all pair types at above chance levels. In addition, performance significantly correlated with the ratio between the numerical values. Although performance was better for simultaneous trials than sequential trials, evidence favoring analog numerical representation emerged from both conditions, and was present even in the first exposure to number pairs. Together, these data favor the interpretation that a single, coherent analog representation system underlies spontaneous quantitative abilities in primates.

  3. Influence of dehydration on locally mediated hindlimb vasodilation in baboons.

    Science.gov (United States)

    Thornton, R M; Proppe, D W

    1988-08-01

    Previous studies indicate that the heat stress-induced cutaneous vasodilation in baboons is attenuated during dehydration by mechanisms other than the well-known neurohumoral vasoconstrictor mechanisms. Therefore, this study sought to determine whether dehydration also attenuates locally mediated maximum hindlimb blood flow and vascular conductance in baboons. Five baboons were chronically instrumented to measure arterial blood pressure and mean external iliac artery blood flow (MIBF). Hindlimb vasodilation was induced by occlusions of the external iliac artery for 2.5, 5.0, 7.5, and 10.0 min and by close-arterial injections of acetylcholine (ACh) and sodium nitroprusside (NP) in graded doses. These vasodilatory stimuli were applied in euhydrated and dehydrated states, the latter being produced by water deprivation for 64-68 h. Maximum MIBF and iliac vascular conductance (IVC) after arterial occlusion were reduced by 67-70% during dehydration. Also, maximum MIBF and IVC produced by ACh in the dehydrated state were 46-52% lower than in the euhydrated state. A similar reduction in the responses to NP occurred during dehydration. It is concluded that the maximum hindlimb blood flow and vascular conductance produced by local, nonneurohumoral mechanisms are attenuated in the baboon during dehydration.

  4. 超声在脑-心双死亡器官捐献供肝体外膜肺氧合模式中的应用价值研究%Application of ultrasound in extracorporeal membrane oxygenation for the liver donation after brain-cardiac death

    Institute of Scientific and Technical Information of China (English)

    朱贤胜; 程琦; 王莎莎; 叶创文; 庞树旺

    2016-01-01

    Objective To evaluate the application value of ultrasound in extracorporeal membrane oxygenation (ECMO)for protecting the liver donation after brain-cardiac death (DBCD).Methods Forty patients with brain death or irreversible brain injury,admitted to Guangzhou General Hospital of Guangzhou Military Command from April 2006 to November 201 4,were eligible for liver donation.The hepatic artery blood flow (QHA),portal vein blood flow (QPV)and ECMO-induced ECMO flow of hepatic artery (VE)of the donor liver were monitored by ultrasound before,5 min after the initiation of ECMO and immediately after ECMO.The changes of total bilirubin (TB),alanine transaminase (ALT)and lactic acid were observed at corresponding time points.Hepatic recovery was subsequently evaluated within 3 months after liver transplantation.Results The mean time of ECMO was (1 .0 ±0.2)h.There was no significant difference in QHA and QPV before and after ECMO (both in P >0.05).And there was no significant difference in liver function parameters before and after ECMO (all in P >0.05).At different time points within postoperative 3 months,the results of ultrasound evaluation and liver function test revealed that the transplant liver function was well recovered in 40 recipients.Conclusions Through monitoring QHA by ultrasound,the best ECMO flow should be chosen,which protects DBCD liver and averts perfusion injury and hypoperfusion.%目的:评价超声在体外膜肺氧合(ECMO)保护脑-心双死亡器官捐献(DBCD)供肝中的应用价值。方法选取2006年4月至2014年11月广州军区广州总医院收治的符合供肝要求的40例脑死亡或不可逆脑损伤患者作为研究对象。分别在 ECMO 运转前、运转后5 min、停转即刻,记录超声监测的供肝肝动脉流量(QHA)、门静脉流量(QPV)及 ECMO 导致的肝动脉 ECMO 流量(VE)。在相应时刻监测供体血液总胆红素(TB)、丙氨酸转氨酶(ALT)、乳酸的变化

  5. Hyperbilirubinemia after extracorporeal circulation surgery: A recent and prospective study

    Institute of Scientific and Technical Information of China (English)

    Yong An; Ying-Bin Xiao; Qian-Jin Zhong

    2006-01-01

    AIM: To clarify the incidence and nature of postoperative hyperbilirubinemia in patients after modern extracorporeal circulation, to analyze possible perioperative risk factors, and to elucidate the clinical significance of postoperative hyperbilirubinemia associated morality and morbidity.METHODS: Between March 2005 and May 2006, three hundred and eighty six consecutive patients undergoing extracorporeal circulation surgery due to a variety of cardiac lesions were investigated prospectively. The incidence of postoperative hyperbilirubinemia was defined as a serum total bilirubin concentration of more than 51 μmol/L. Several perioperative parameters were compared by logistic regression between hyperbilirubinemia and non-hyperbilirubinemia patients to determine possible risk factors contributing to postoperative hyperbilirubinemia and mortality.RESULTS: Overall incidence of postoperative hyperbilirubinemia was 25.3% (98/386). In patients with postoperative hyperbilirubinemia, 56.2%reached peak total bilirubin concentration on the first postoperative day, 33.5% on the second day, and 10.3%on the seventh day. Eighty percent of the increase of total bilirubin resulted from an increase of both conjugated and unconjugated bilirubin. Development of postoperative hyperbilirubinemia was associated with a higher mortality (P < 0.01), longer duration of mechanical ventilation (P < 0.05) and longer ICU stay time (P < 0.05). Preoperative total bilirubin concentration, preoperative right atrium pressure,numbers of valves replaced and of blood transfusion requirement were identified as important predictors for postoperative hyperbilirubinemia.CONCLUSION: Early postoperative hyperbilirubinemia after modern extracorporeal circulation is mainly caused by an increase in both conjugated and unconjugated bilirubin, and is associated with a high mortality.Important contributing factors are the preoperative total bilirubin concentration, preoperative severity of right atrial

  6. Cyclohexanone contamination from extracorporeal circuits impairs cardiovascular function.

    Science.gov (United States)

    Thompson-Torgerson, Caitlin S; Champion, Hunter C; Santhanam, Lakshmi; Harris, Z Leah; Shoukas, Artin A

    2009-06-01

    Extracorporeal circulation provides critical life support in the face of cardiopulmonary or renal failure, but it also introduces a host of unique morbidities characterized by edema formation, cardiac insufficiency, autonomic dysfunction, and altered vasomotor function. We tested the hypothesis that cyclohexanone (CHX), a solvent used in production of extracorporeal circuits and intravenous (IV) bags, leaches into the contained fluids and can replicate these clinical morbidities. Crystalloid fluid samples from circuits and IV bags were analyzed by gas chromatography-mass spectrometry to provide a range of clinical CHX exposure levels, revealing CHX contamination of sampled fluids (9.63-3,694 microg/l). In vivo rat studies were conducted (n = 49) to investigate the effects of a bolus IV infusion of CHX vs. saline alone on cardiovascular function, baroreflex responsiveness, and edema formation. Cardiovascular function was evaluated by cardiac output, heart rate, stroke volume, vascular resistance, arterial pressure, and ventricular contractility. Baroreflex function was assessed by mean femoral arterial pressure responses to bilateral carotid occlusion. Edema formation was assessed by the ratio of wet to dry organ weights for lungs, liver, kidneys, and skin. CHX infusion led to systemic hypotension; pulmonary hypertension; depressed contractility, heart rate, stroke volume, and cardiac output; and elevated vascular resistance (P < 0.05). Mean arterial pressure responsiveness to carotid occlusion was dampened after CHX infusion (from +17.25 +/- 1.8 to +5.61 +/- 3.2 mmHg; P < 0.05). CHX infusion led to significantly higher wet-to-dry weight ratios vs. saline only (3.8 +/- 0.06 vs. 3.5 +/- 0.05; P < 0.05). CHX can reproduce clinical cardiovascular, neurological, and edema morbidities associated with extracorporeal circulatory treatment.

  7. Focused grooming networks and stress alleviation in wild female baboons.

    Science.gov (United States)

    Wittig, Roman M; Crockford, Catherine; Lehmann, Julia; Whitten, Patricia L; Seyfarth, Robert M; Cheney, Dorothy L

    2008-06-01

    We examine the relationship between glucocorticoid (GC) levels and grooming behavior in wild female baboons during a period of instability in the alpha male rank position. All females' GC levels rose significantly at the onset of the unstable period, though levels in females who were at lower risk of infanticide began to decrease sooner in the following weeks. Three factors suggest that females relied on a focused grooming network as a coping mechanism to alleviate stress. First, all females' grooming networks became less diverse in the weeks following the initial upheaval. Second, females whose grooming had already focused on a few predictable partners showed a less dramatic rise in GC levels than females whose grooming network had been more diverse. Third, females who contracted their grooming network the most experienced a greater decrease in GC levels in the following week. We conclude that close bonds with a few preferred partners allow female baboons to alleviate the stress associated with social instability.

  8. Giant cell lichenoid dermatitis in a patient with baboon syndrome.

    Science.gov (United States)

    Khelifa-Hamdani, Elhem; Touati-Serraj, Monia; Perriard, Jacqueline; Chavaz, Pierre; Saurat, Jean-Hilaire; Kaya, Gürkan

    2008-10-01

    Giant cell lichenoid dermatitis is a recently described pathological entity, which can be seen as an unusual lichenoid drug eruption, a manifestation of sarcoidosis or within herpes zoster scars. Histopathological findings include focal vacuolar alteration of the basal layer with cytoid bodies, dermal and intraepidermal multinucleated giant cells and a mixed chronic inflammatory infiltrate with a lichenoid pattern consisting of lymphocytes, histiocytes, eosinophils and plasma cells. Here, we report a giant cell lichenoid dermatitis in a 41-year-old male patient who developed, 3 days after intravenous treatment with amoxicillin-clavulanic acid for erysipelas of the left leg, a clinical picture suggesting a baboon syndrome characterized by an erythematous and pruritic eruption on the axillary, inguinal and popliteal areas and the anterior side of elbows. This is the first reported case of giant cell lichenoid dermatitis in a patient with baboon syndrome.

  9. Detective mice assess relatedness in baboons using olfactory cues.

    Science.gov (United States)

    Célérier, Aurélie; Huchard, Elise; Alvergne, Alexandra; Féjan, Delphine; Plard, Floriane; Cowlishaw, Guy; Raymond, Michel; Knapp, Leslie A; Bonadonna, Francesco

    2010-05-01

    The assessment of relatedness may be crucial in the evolution of socio-sexual behaviour, because it can be associated with fitness benefits mediated by both nepotism and inbreeding avoidance. In this context, one proposed mechanism for kin recognition is 'phenotype matching'; animals might compare phenotypic similarities between themselves and others in order to assess the probability that they are related. Among cues potentially used for kin discrimination, body odours constitute interesting candidates that have been poorly investigated in anthropoid primates so far, because of a mixture of theoretical considerations and methodological/experimental constraints. In this study, we used an indirect approach to examine the similarity in odour signals emitted by related individuals from a natural population of chacma baboons (Papio ursinus). For that purpose, we designed an innovative behavioural tool using mice olfactory abilities in a habituation-discrimination paradigm. We show that: (i) mice can detect odour differences between individuals of same sex and age class in another mammal species, and (ii) mice perceive a higher odour similarity between related baboons than between unrelated baboons. These results suggest that odours may play a role in both the signalling of individual characteristics and of relatedness among individuals in an anthropoid primate. The 'biological olfactometer' developed in this study offers new perspectives to the exploration of olfactory signals from a range of species.

  10. Baboon feeding ecology informs the dietary niche of Paranthropus boisei.

    Directory of Open Access Journals (Sweden)

    Gabriele A Macho

    Full Text Available Hominins are generally considered eclectic omnivores like baboons, but recent isotope studies call into question the generalist status of some hominins. Paranthropus boisei and Australopithecus bahrelghazali derived 75%-80% of their tissues' δ(13C from C4 sources, i.e. mainly low-quality foods like grasses and sedges. Here I consider the energetics of P. boisei and the nutritional value of C4 foods, taking into account scaling issues between the volume of food consumed and body mass, and P. boisei's food preference as inferred from dento-cranial morphology. Underlying the models are empirical data for Papio cynocephalus dietary ecology. Paranthropus boisei only needed to spend some 37%-42% of its daily feeding time (conservative estimate on C4 sources to meet 80% of its daily requirements of calories, and all its requirements for protein. The energetic requirements of 2-4 times the basal metabolic rate (BMR common to mammals could therefore have been met within a 6-hour feeding/foraging day. The findings highlight the high nutritional yield of many C4 foods eaten by baboons (and presumably hominins, explain the evolutionary success of P. boisei, and indicate that P. boisei was probably a generalist like other hominins. The diet proposed is consistent with the species' derived morphology and unique microwear textures. Finally, the results highlight the importance of baboon/hominin hand in food acquisition and preparation.

  11. Extracorporeal shock wave lithotripsy in childhood

    Energy Technology Data Exchange (ETDEWEB)

    Kroovand, R.L.; Harrison, L.H.; McCullough, D.L.

    1987-10-01

    Extracorporeal shock wave lithotripsy is the treatment of choice for the majority of upper urinary calculi in adults. Technical limitations, including patient size and concerns over post-treatment stone fragment passage, have made the application of extracorporeal shock wave lithotripsy in children less clearly defined. We report the successful application of the Dornier lithotriptor in the management of 18 children (22 kidneys) with upper urinary calculi.

  12. In vivo regulation of hepatic LDL receptor mRNA in the baboon. Differential effects of saturated and unsaturated fat.

    Science.gov (United States)

    Fox, J C; McGill, H C; Carey, K D; Getz, G S

    1987-05-25

    The effects of diets enriched with cholesterol and different fats upon plasma lipoproteins and hepatic low density lipoprotein (LDL) receptor mRNA levels were studied in a group of 18 normal baboons. Animals were fed diets containing 1% cholesterol and 25% fat as either coconut oil, peanut oil, or olive oil for a period of 20 weeks. Plasma total cholesterol, high density lipoprotein (HDL) cholesterol, beta-lipoprotein (LDL + very low density lipoprotein) cholesterol, apolipoprotein B and apolipoprotein A-I were measured in samples obtained at 4-week intervals. All three diet groups demonstrated a statistically significant increase in plasma cholesterol as compared to base line throughout the experiment. Hepatic LDL receptor (LDL-R) mRNA levels were quantified by dot blot hybridization in serial liver biopsies. Animals fed saturated fat sustained a significant reduction in hepatic LDL-R mRNA as compared to those fed either monounsaturated or polyunsaturated fat. A strong negative correlation between LDL-R mRNA and plasma total cholesterol (r = -0.71), HDL cholesterol (r = -0.76), and plasma apo A-I (r = -0.77) was observed only in those animals fed coconut oil. Weak negative correlations between LDL-R mRNA and other plasma parameters did not achieve statistical significance. We conclude that saturated and unsaturated oils may influence plasma cholesterol levels in part through differential effects on LDL receptor biosynthesis in baboons.

  13. Surgical myocardial revascularization without extracorporeal circulation

    Directory of Open Access Journals (Sweden)

    Salomón Soriano Ordinola Rojas

    2003-05-01

    Full Text Available OBJECTIVE: To assess the immediate postoperative period of patients undergoing myocardial revascularization without extracorporeal circulation with different types of grafts. METHODS: One hundred and twelve patients, 89 (79.5% of whom were males, were revascularized without extracorporeal circulation. Their ages ranged from 39 to 85 years. The criteria for indicating myocardial revascularization without extracorporeal circulation were as follows: revascularized coronary artery caliber > 1.5 mm, lack of intramyocardial trajectory on coronary angiography, noncalcified coronary arteries, and tolerance of the heart to the different rotation maneuvers. RESULTS: Myocardial revascularization without extracorporeal circulation was performed in 112 patients. Three were converted to extracorporeal circulation, which required a longer hospital stay but did not impact mortality. During the procedure, the following events were observed: atrial fibrillation in 10 patients, ventricular fibrillation in 4, total transient atrioventricular block in 2, ventricular extrasystoles in 58, use of a device to retrieve red blood cells in 53, blood transfusion in 8, and arterial hypotension in 89 patients. Coronary angiography was performed in 20 patients on the seventh postoperative day when the grafts were patent. CONCLUSION: Myocardial revascularization without extracorporeal circulation is a reproducible technique that is an alternative for treating ischemic heart disease.

  14. Inflammatory response and extracorporeal circulation.

    Science.gov (United States)

    Kraft, Florian; Schmidt, Christoph; Van Aken, Hugo; Zarbock, Alexander

    2015-06-01

    Patients undergoing cardiac surgery with extracorporeal circulation (EC) frequently develop a systemic inflammatory response syndrome. Surgical trauma, ischaemia-reperfusion injury, endotoxaemia and blood contact to nonendothelial circuit compounds promote the activation of coagulation pathways, complement factors and a cellular immune response. This review discusses the multiple pathways leading to endothelial cell activation, neutrophil recruitment and production of reactive oxygen species and nitric oxide. All these factors may induce cellular damage and subsequent organ injury. Multiple organ dysfunction after cardiac surgery with EC is associated with an increased morbidity and mortality. In addition to the pathogenesis of organ dysfunction after EC, this review deals with different therapeutic interventions aiming to alleviate the inflammatory response and consequently multiple organ dysfunction after cardiac surgery.

  15. Efficacy of fenbendazole and milbemycin oxime for treating baboons (Papio cynocephalus anubis) infected with Trichuris trichiura.

    Science.gov (United States)

    Reichard, Mason V; Wolf, Roman F; Carey, David W; Garrett, Jennifer Jane; Briscoe, Heather A

    2007-03-01

    We evaluated the efficacy of fenbendazole (FBZ) and milbemycin oxime (MO) in the treatment of baboons (Papio cynocephalus anubis) with naturally acquired Trichuris trichiura infection by comparing fecal egg count reduction (FECR) tests. We assigned 7 baboons, each singly housed and confirmed infected with T. trichiura, to treatment groups of FBZ (n=3) or MO (n=3), or as a control (n=1). All (100%) baboons that received FBZ stopped shedding T. trichiura eggs within 6 d of treatment, and fecal egg counts remained negative at 65 d after treatment. Although the number of T. trichiura eggs shed per gram of feces from 2 (67%) baboons decreased significantly after the second treatment with MO, this regimen never totally eliminated eggs of T. trichiura. The results of our study indicate that FBZ was more effective for treating baboons with T. trichiura than was MO.

  16. Upper limit of cerebral blood flow autoregulation in experimental renovascular hypertension in the baboon

    DEFF Research Database (Denmark)

    Strandgaard, S; Jones, J V; MacKenzie, E T;

    1975-01-01

    The effect of arterial hypertension on cerebral blood flow was studied by the intracarotid 133Xe clearance method in baboons. The arterial blood pressure was raised in gradual steps with angiotensin. Baboons with renal hypertension of 8-12 weeks duration were studied along with normotensive baboons....... In initially normotensive baboons, cerebral blood flow remained constant until the mean arterial blood pressure had risen to the range of 140 to 154 mm Hg; thereafter cerebral blood flow increased with each rise in mean arterial blood pressure. In the chronically hypertensive baboons, cerebral blood flow...... remained constant until the mean arterial blood pressure had been elevated to the range of 155 to 169 mm Hg. Thus, in chronic hypertension it appears that there are adaptive changes in the cerebral circulation which may help to protect the brain from further increases in arterial blood pressure....

  17. NOD/SCID repopulating cells contribute only to short-term repopulation in the baboon.

    Science.gov (United States)

    Mezquita, P; Beard, B C; Kiem, H-P

    2008-11-01

    We have previously compared the repopulation ability of gene-modified baboon CD34+ cells in an autologous transplantation versus a xenotransplant model in irradiated nonobese diabetic/severe combined immune deficiency (NOD/SCID) mice. Baboon CD34-selected marrow cells were transduced with a gammaretrovirus vector and infused into irradiated baboons and NOD/SCID mice. A limited integration-site analysis could only detect two common retrovirus integration sites in the NOD/SCID and monkey. Here, we performed locus-specific PCR on 30 clones recovered from NOD/SCID beta2-microglobulin mice reconstituted with transduced baboon CD34+ cells. We identified five common integrants in the baboon early after transplant (2-6 weeks) but none during the long-term follow-up (6 and 12 months). These results confirm that repopulating cells in the NOD/SCID mouse contribute only to short-term repopulation in a clinically relevant large animal model.

  18. State of the art extracorporeal shock wave lithotripsy

    Energy Technology Data Exchange (ETDEWEB)

    Kandel, L.B. (State Univ. of New York at Stony Brook, Stony Brook, NY (US)); Harrison, L.H.; McCullough, D.L. (Wake Forest Univ. Medical Center, Winston-Salem, NC (US))

    1987-01-01

    This book contains 16 chapters. Some of the topics that are covered are: Extracorporeal Shock Wave Lithotripsy Development; Laser-Generated Extracorporeal Shock Wave Lithotripter; Radiation Exposure during ESWL; Caliceal Calculi; and Pediatric ESWL.

  19. Extracorporal hemodialysis with acute or decompensated chronical hepatic failure

    Directory of Open Access Journals (Sweden)

    Wasem, Jürgen

    2006-04-01

    Full Text Available Background: Conventional diagnostic procedures and therapy of acute liver failure (ALF and acute-on-chronic liver failure (ACLF focus on to identify triggering events of the acute deterioration of the liver function and to avoid them. Further objectives are to prevent the development respectively the progression of secondary organ dysfunctions or organ failure. Most of the times the endocrinological function of the liver can to a wide extent be compensated, but the removal of toxins can only marginally be substituted by conventional conservative therapy. To improve this component of the liver function is the main objective of extracorporal liver support systems. The following principles of liver support systems can be differentiated: Artificial systems, bioartifical systems and extracorporal liver perfusion systems. This HTA report focuses on artificial systems (e.g. BioLogic-DT/-DTPF, MARS, Prometheus, because only these approaches currently are relevant in the German health care system. In 2004 a category "Extracorporal liver assist device" was introduced in the list of "additional payments" in the German DRG-system, which makes reimbursement for hospitals using the technology in inpatient care possible, based on an hospital's individual contract with statutory sickness funds. Objectives: To report the present evidence and future research need on medical efficacy and economic effectiveness of extracorporal liver support devices for treatment of patients with ALF or ACLF based on published literature data. Are artificial liver support systems efficient and effective in the treatment of ALF or ACLF? Methods: An extensive, systematic literature search in medical, economic, and HTA literature data bases was performed. Relevant data were extracted and synthesised. Results: Relevant controlled trials were detected for BioLogic-DT and MARS. No randomised controlled trial on Prometheus was found. None of the included studies on BioLogic-DT showed

  20. Taste responses to neohesperidin dihydrochalcone in rats and baboon monkeys.

    Science.gov (United States)

    Naim, M; Rogatka, H; Yamamoto, T; Zehavi, U

    1982-06-01

    Preference-aversion behavior to solutions containing neohesperidin dihydrochalcone (NHDHC) was studied rats and baboon monkeys. Electrophysiological responses evoked by application of NHDHC solutions to taste receptors innervated by the chorda tympani and the glossopharyngeal nerves were also measured. As a group, rats were indifferent to solutions containing up to 1.2 x 10(-3) M NHDHC in short and long-term preference tests. A solution containing the very high concentration of 8.2 x 10(-3) M NHDHC was consumed less than water by all rats. The aversive behavior of rats to the 8.2 x 10(-3) M NHDHC solution appeared to be due to taste quality rather than olfaction. When percent preferences were calculated on an individual basis for the long-term preference tests, 59% of the rats were indifferent to solutions containing up to 1.2 x 10(-3) M NHDHC, 33% of the animals found this solution aversive and less than 8% showed preference. Behavioral responses to a solution of 3.4 x 10(-4) M aspartame also varied considerably among rats. The electrophysiological data were in line with the behavioral responses suggesting weak taste responses for NHDHC in rats. More pronounced responses observed in the glossopharyngeal nerve as compared to the chorda tympani. Baboon monkeys showed a strong preference for solutions containing 1.6 x 10(-5) M-1.6 x 10(-3) M NHDHC. A solution of 1.6 x 10(-2) M was consumed to a lesser extent than water. It is concluded that baboon monkeys present a better experimental model than rats for investigating the sweetness of NHDHC.

  1. Learning of spatial statistics in nonhuman primates: contextual cueing in baboons (Papio papio).

    Science.gov (United States)

    Goujon, Annabelle; Fagot, Joel

    2013-06-15

    A growing number of theories of cognition suggest that many of our behaviors result from the ability to implicitly extract and use statistical redundancies present in complex environments. In an attempt to develop an animal model of statistical learning mechanisms in humans, the current study investigated spatial contextual cueing (CC) in nonhuman primates. Twenty-five baboons (Papio papio) were trained to search for a target (T) embedded within configurations of distrators (L) that were either predictive or non-predictive of the target location. Baboons exhibited an early CC effect, which remained intact after a 6-week delay and stable across extensive training of 20,000 trials. These results demonstrate the baboons' ability to learn spatial contingencies, as well as the robustness of CC as a cognitive phenomenon across species. Nevertheless, in both the youngest and oldest baboons, CC required many more trials to emerge than in baboons of intermediate age. As a whole, these results reveal strong similarities between CC in humans and baboons, suggesting similar statistical learning mechanisms in these two species. Therefore, baboons provide a valid model to investigate how statistical learning mechanisms develop and/or age during the life span, as well as how these mechanisms are implemented in neural networks, and how they have evolved throughout the phylogeny.

  2. Use of extracorporeal membrane oxygenation in adults.

    Science.gov (United States)

    Lafç, Gökhan; Budak, Ali Baran; Yener, Ali Ümit; Cicek, Omer Faruk

    2014-01-01

    Since the first successful application of the heart-lung machine in 1953 by John Gibbon [1], great efforts have been made to modify the bypass techniques and devices in order to allow prolonged extracorporeal circulation in the intensive care unit (ICU), commonly referred to as extracorporeal membrane oxygenation (ECMO). ECMO uses classic cardiopulmonary bypass technology to support circulation. It provides continuous, non-pulsatile cardiac output and extracorporeal oxygenation [2]. Veno-venous ECMO (VV ECMO) provides respiratory support, while veno-arterial ECMO (VA ECMO) provides cardio-respiratory support to patients with severe but potentially reversible cardiac or respiratory deterioration refractory to standard therapeutic modalities. ECMO is a temporary form of life support providing a prolonged biventricular circulatory and pulmonary support for patients experiencing both pulmonary and cardiac failure unresponsive to conventional therapy. Despite the advent of newer ventricular assist devices that are more suitable for long term support, ECMO is simple to establish, cost-effective to operate.

  3. [Treatment of hydroxychloroquine poisoning with extracorporeal circulation].

    Science.gov (United States)

    Mongenot, F; Gonthier, Y Tessier; Derderian, F; Durand, M; Blin, D

    2007-02-01

    We report a case of massive overdose of hydroxychloroquine treated with circulatory assistance by peripheral extracorporeal circulation (ECC). We expose the case of a 39-year-old woman who ingested 12 g of hydroxychloroquine with bromazepam, paroxetine, and zolpidem, in a suicide attempt. Patient has developed central nervous system depression, hemodynamic failure, life-threatening ventricular arrhythmias, and serious hypokalemia. Initially the patient has received conventional treatment with gastric lavage and activated charcoal for gastrointestinal decontamination, blood volume expansion and vasopressive drugs, intubation and mechanical ventilation, high dose of diazepam, and potassium replacement. A ventricular fibrillation was treated with external cardiac massage. In spite of this treatment, cardiogenic shock was uncontrolled, and imposed circulatory assistance. After extracorporeal circulation, we observed a spectacular improvement of hemodynamic parameters and electrocardiographic normalization at day one. Extracorporeal circulation could be used as a rescue treatment of cardiotrope and hydroxychloroquine overdoses.

  4. Out of Africa, but how and when? The case of hamadryas baboons (Papio hamadryas).

    Science.gov (United States)

    Kopp, Gisela H; Roos, Christian; Butynski, Thomas M; Wildman, Derek E; Alagaili, Abdulaziz N; Groeneveld, Linn F; Zinner, Dietmar

    2014-11-01

    Many species of Arabian mammals are considered to be of Afrotropical origin and for most of them the Red Sea has constituted an obstacle for dispersal since the Miocene-Pliocene transition. There are two possible routes, the 'northern' and the 'southern', for terrestrial mammals (including humans) to move between Africa and Arabia. The 'northern route', crossing the Sinai Peninsula, is confirmed for several taxa by an extensive fossil record, especially from northern Egypt and the Levant, whereas the 'southern route', across the Bab-el-Mandab Strait, which links the Red Sea with the Gulf of Aden, is more controversial, although post-Pliocene terrestrial crossings of the Red Sea might have been possible during glacial maxima when sea levels were low. Hamadryas baboons (Papio hamadryas) are the only baboon taxon to disperse out of Africa and still inhabit Arabia. In this study, we investigate the origin of Arabian hamadryas baboons using mitochondrial sequence data from 294 samples collected in Arabia and Northeast Africa. Through the analysis of the geographic distribution of genetic diversity, the timing of population expansions, and divergence time estimates combined with palaeoecological data, we test: (i) if Arabian and African hamadryas baboons are genetically distinct; (ii) if Arabian baboons exhibit population substructure; and (iii) when, and via which route, baboons colonized Arabia. Our results suggest that hamadryas baboons colonized Arabia during the Late Pleistocene (130-12 kya [thousands of years ago]) and also moved back to Africa. We reject the hypothesis that hamadryas baboons were introduced to Arabia by humans, because the initial colonization considerably predates the earliest records of human seafaring in this region. Our results strongly suggest that the 'southern route' from Africa to Arabia could have been used by hamadryas baboons during the same time period as proposed for modern humans. Copyright © 2014 The Authors. Published by Elsevier

  5. Whole body [{sup 11}C]-dihydrotetrabenazine imaging of baboons: biodistribution and human radiation dosimetry estimates

    Energy Technology Data Exchange (ETDEWEB)

    Murthy, Rajan [Columbia University College of Physicians and Surgeons, Department of Psychiatry, New York, NY (United States); New York State Psychiatric Institute, Department of Neuroscience, Division of Brain Imaging, New York, NY (United States); Harris, Paul; Leibel, Rudolph [Columbia University College of Physicians and Surgeons, Department of Medicine, New York, NY (United States); Simpson, Norman; Parsey, Ramin [Columbia University College of Physicians and Surgeons, Department of Psychiatry, New York, NY (United States); Van Heertum, Ronald [Columbia University College of Physicians and Surgeons, Department of Radiology, New York, NY (United States); New York State Psychiatric Institute, Department of Neuroscience, Division of Brain Imaging, New York, NY (United States); Mann, J.J. [Columbia University College of Physicians and Surgeons, Department of Psychiatry, New York, NY (United States); Columbia University College of Physicians and Surgeons, Department of Radiology, New York, NY (United States); New York State Psychiatric Institute, Department of Neuroscience, Division of Brain Imaging, New York, NY (United States)

    2008-04-15

    Vesicular monoamine transporter type 2 abundance quantified using the radiotracer [{sup 11}C]-dihydrotetrabenazine (DTBZ) has been used to study diagnosis and pathogenesis of dementia and psychiatric disorders in humans. In addition, it may be a surrogate marker for insulin-producing pancreatic beta cell mass, useful for longitudinal measurements using positron emission tomography to track progression of autoimmune diabetes. To support the feasibility of long-term repeated administrations, we estimate the biodistribution and dosimetry of [{sup 11}C]-DTBZ in humans. Five baboon studies were acquired using a Siemens ECAT camera. After transmission scanning, 165-210 MBq of [{sup 11}C]-DTBZ were injected, and dynamic whole body emission scans were conducted. Time-activity data were used to obtain residence times and estimate absorbed radiation dose according to the MIRD model. Most of the injected tracer localized to the liver and the lungs, followed by the intestines, brain, and kidneys. The highest estimated absorbed radiation dose was in the stomach wall. The largest radiation dose from [{sup 11}C]-DTBZ is to the stomach wall. This dose estimate, as well as the radiation dose to other radiosensitive organs, must be considered in evaluating the risks of multiple administrations. (orig.)

  6. Sexual swellings advertise female quality in wild baboons.

    Science.gov (United States)

    Domb, L G; Pagel, M

    2001-03-08

    The females of many Old World primate species produce prominent and conspicuous swellings of the perineal skin around the time of ovulation. These sexual swellings have been proposed to increase competition among males for females or to increase the likelihood of a female getting fertilized, by signalling either a female's general reproductive status, or the timing of her ovulation. Here we show that sexual swellings in wild baboons reliably advertise a female's reproductive value over her lifetime, in accordance with a theoretical model of honest signalling. Females with larger swellings attained sexual maturity earlier, produced both more offspring and more surviving offspring per year than females with smaller swellings, and had a higher overall proportion of their offspring survive. Male baboons use the size of the sexual swelling to determine their mating effort, fighting more aggressively to consort females with larger swellings, and spending more time grooming these females. Our results document an unusual case of a sexually selected ornament in females, and show how males, by mating selectively on the basis of the size of the sexual swelling, increase their probability of mating with females more likely to produce surviving offspring.

  7. Baboons, like humans, solve analogy by categorical abstraction of relations.

    Science.gov (United States)

    Flemming, Timothy M; Thompson, Roger K R; Fagot, Joël

    2013-05-01

    Reasoning by analogy is one of the most complex and highly adaptive cognitive processes in abstract thinking. For humans, analogical reasoning entails the judgment and conceptual mapping of relations-between-relations and is facilitated by language (Gentner in Cogn Sci 7:155-170, 1983; Premack in Thought without language, Oxford University Press, New York, 1986). Recent evidence, however, shows that monkeys like "language-trained" apes exhibit similar capacity to match relations-between-relations (Fagot and Thompson in Psychol Sci 22:1304-1309, 2011; Flemming et al. in J Exp Psychol: Anim Behav Process 37:353-360, 2011; Truppa et al. in Plos One 6(8):e23809, 2011). Whether this behavior is driven by the abstraction of categorical relations or alternatively by direct perception of variability (entropy) is crucial to the debate as to whether nonhuman animals are capable of analogical reasoning. In the current study, we presented baboons (Papio papio) and humans (Homo sapiens) with a computerized same/different relational-matching task that in principle could be solved by either strategy. Both baboons and humans produced markedly similar patterns of responding. Both species responded different when the perceptual variability of a stimulus array fell exactly between or even closer to that of a same display. Overall, these results demonstrate that categorical abstraction trumped perceptual properties and, like humans, Old World monkeys can solve the analogical matching task by judging the categorical abstract equivalence of same/different relations-between-relations.

  8. Treatment of acetaminophen-induced hepatitis and fulminant hepatic failure with extracorporeal sorbent-based devices.

    Science.gov (United States)

    Ash, Stephen R; Caldwell, Cary A; Singer, Greg G; Lowell, Jeff A; Howard, Todd K; Rustgi, Vinod K

    2002-01-01

    When a patient with acetaminophen overdose arrives in the emergency room more than 14 hours after ingestion, the value of N-acetylcysteine is unproven and patient mortality is at least 10%. Anecdotal case reports have indicated benefit of extracorporeal detoxification of these late-arriving patients with acetaminophen overdose. We identified 10 patients with serious acetaminophen overdose, 8 that arrived in the emergency room 16 to 44 hours after acetaminophen overdose with plasma levels predicting severe hepatic toxicity, and 2 that arrived in the emergency room 8 to 12 hours after overdose but with exceedingly high levels. All patients developed severe hepatitis (mean peak alanine aminotransferase, 4,052; mean peak protime, 25 seconds). At 16 to 68 hours after overdose, the patients were treated for 4 to 6 hours with the Liver Dialysis System (Hemocleanse Inc, W. Lafayette, IN), a single-access hemodiabsorption system indicated for treatment of serious drug overdose and for treatment of hepatic encephalopathy. Acetaminophen levels fell an average of 73% during treatment. Treatment was repeated 24 or 48 hours later if acetaminophen was still measurable in plasma. All 10 patients recovered intrinsic liver function and general health, with liver enzymes starting to normalize 24 hours after treatment, and were discharged 3 to 7 days after overdose. No patient required liver transplant. Because market introduction of Liver Dialysis, there have been 40 more patients with acetaminophen-induced hepatotoxicity treated with Liver Dialysis. All have recovered liver function without long-term sequelae. Though most of these patients with already established hepatic toxicity from acetaminophen would recover without extracorporeal blood therapy, treatment with the Liver Dialysis System should assure recovery from acute hepatic failure, and may shorten the clinical course of the illness.

  9. Severe hypoxemia during veno-venous extracorporeal membrane oxygenation: exploring the limits of extracorporeal respiratory support

    Directory of Open Access Journals (Sweden)

    Liane Brescovici Nunes

    2014-03-01

    Full Text Available OBJECTIVE: Veno-venous extracorporeal oxygenation for respiratory support has emerged as a rescue alternative for patients with hypoxemia. However, in some patients with more severe lung injury, extracorporeal support fails to restore arterial oxygenation. Based on four clinical vignettes, the aims of this article were to describe the pathophysiology of this concerning problem and to discuss possibilities for hypoxemia resolution. METHODS: Considering the main reasons and rationale for hypoxemia during veno-venous extracorporeal membrane oxygenation, some possible bedside solutions must be considered: 1 optimization of extracorporeal membrane oxygenation blood flow; 2 identification of recirculation and cannula repositioning if necessary; 3 optimization of residual lung function and consideration of blood transfusion; 4 diagnosis of oxygenator dysfunction and consideration of its replacement; and finally 5 optimization of the ratio of extracorporeal membrane oxygenation blood flow to cardiac output, based on the reduction of cardiac output. CONCLUSION: Therefore, based on the pathophysiology of hypoxemia during veno-venous extracorporeal oxygenation support, we propose a stepwise approach to help guide specific interventions.

  10. Extracorporeal total artificial heart as bailout surgery.

    Science.gov (United States)

    Perrodin, Stéphanie F; Muller, Olivier; Gronchi, Fabrizio; Liaudet, Lucas; Hullin, Roger; Kirsch, Matthias

    2017-03-01

    We report the use of a total extracorporeal heart for uncontrolled bleeding following a proximal left anterior descending artery perforation, using two centrifugal ventricular assist devices after heart explantation. The literature describing similar techniques and patient outcomes for this "bailout" technique are reviewed.

  11. Extracorporeal shockwave therapy in musculoskeletal disorders

    OpenAIRE

    Wang Ching-Jen

    2012-01-01

    Abstract The sources of shockwave generation include electrohydraulic, electromagnetic and piezoelectric principles. Electrohydraulic shockwaves are high-energy acoustic waves generated under water explosion with high voltage electrode. Shockwave in urology (lithotripsy) is primarily used to disintegrate urolithiasis, whereas shockwave in orthopedics (orthotripsy) is not used to disintegrate tissues, rather to induce tissue repair and regeneration. The application of extracorporeal shockwave ...

  12. Guidelines on the use of extracorporeal photopheresis

    DEFF Research Database (Denmark)

    Knobler, R; Berlin, G; Calzavara-Pinton, P;

    2014-01-01

    BACKGROUND: After the first investigational study on the use of extracorporeal photopheresis for the treatment of cutaneous T-cell lymphoma was published in 1983 with its subsequent recognition by the FDA for its refractory forms, the technology has shown significant promise in the treatment...

  13. Surfactant phosphatidylcholine half-life and pool size measurements in premature baboons developing bronchopulmonary dysplasia

    NARCIS (Netherlands)

    D.J. Janssen; V.P. Carnielli (Virgilio); P.E. Cogo (Paola); S.R. Seidner; I.H.I. Luijendijk; J.L.D. Wattimena (Josias); A.H. Jobe (Alan); L.J.I. Zimmermann (Luc)

    2002-01-01

    textabstractBecause minimal information is available about surfactant metabolism in bronchopulmonary dysplasia, we measured half-lives and pool sizes of surfactant phosphatidylcholine in very preterm baboons recovering from respiratory distress syndrome and developing

  14. GROUP DECISIONS. Shared decision-making drives collective movement in wild baboons.

    Science.gov (United States)

    Strandburg-Peshkin, Ariana; Farine, Damien R; Couzin, Iain D; Crofoot, Margaret C

    2015-06-19

    Conflicts of interest about where to go and what to do are a primary challenge of group living. However, it remains unclear how consensus is achieved in stable groups with stratified social relationships. Tracking wild baboons with a high-resolution global positioning system and analyzing their movements relative to one another reveals that a process of shared decision-making governs baboon movement. Rather than preferentially following dominant individuals, baboons are more likely to follow when multiple initiators agree. When conflicts arise over the direction of movement, baboons choose one direction over the other when the angle between them is large, but they compromise if it is not. These results are consistent with models of collective motion, suggesting that democratic collective action emerging from simple rules is widespread, even in complex, socially stratified societies.

  15. Studies on the cerebral circulation of the baboon in acutely induced hypertension

    DEFF Research Database (Denmark)

    Strandgaard, S; MacKenzie, E T; Jones, J V

    1976-01-01

    The upper limit autoregulation of cerebral blood flow was investigated in eight young baboons with the intracarotid 133xenon clearance method. Blood pressure was increased by intravenous angiotensin infusion. Autoregulation was effective during blood pressure increase from normotensive levels...

  16. [Newborn life threatening respiratory failure treatment with extracorporeal membrane oxygenation].

    Science.gov (United States)

    Urbańska, Ewa; Grzybowski, Adam; Haponiuk, Ireneusz; Przybylski, Roman; Walas, Wojciech; Stempniewicz, Krzysztof; Szary, Tomasz; Włoczka, Grzegorz; Skalski, Janusz H; Zembala, Marian

    2006-01-01

    THE AIM of the study was to show first results of newborn life threatening respiratory failure treatment with extracorporeal membrane oxygenation (ECMO) in Poland. Nine newborns were treated with extracorporeal membrane oxygenation in Silesian Center for Heart Diseases. Newborns were born in 38 week of gestational age (36-41 weeks) with mean birth weight of 3490 g. Reasons for the referral were: meconium aspiration syndrome, infection, and pulmonary hypertension. Each newborn fulfilled an Extracorporeal Life Support Organization (ELSO) criteria for extracorporeal membrane oxygenation. seven out of nine of patients treated with extracorporeal membrane oxygenation survived. Full clinical stabilization was reached about 6th hour of treatment. Mean extracorporeal oxygenation time was 162 hours. For eight newborns veno-venous method was applied and for one newborn veno-arterial method. Roller pump was used in 7 cases and centrifugal pomp in one case. Five newborns had uneventful treatment. During extracorporeal membrane oxygenation therapy we have observed several complications: PDA, hemorrhagic complications, renal failure, arterial hypertension, septicemia, tubing rupture. extracorporeal oxygenation is an effective method of treatment for newborn life threatening respiratory failure. Obtained results do not differ much from Extracorporeal Life Support Organization register results. The most essential problem for extracorporeal membrane oxygenation therapy is correct qualification, early referral, safe transportation as well as the development of centers providing ECMO treatment.

  17. High Prevalence of Antibodies against the Bacterium Treponema pallidum in Senegalese Guinea Baboons (Papio papio).

    Science.gov (United States)

    Knauf, Sascha; Barnett, Ulrike; Maciej, Peter; Klapproth, Matthias; Ndao, Ibrahima; Frischmann, Sieghard; Fischer, Julia; Zinner, Dietmar; Liu, Hsi

    2015-01-01

    The bacterium Treponema pallidum is known to cause syphilis (ssp. pallidum), yaws (ssp. pertenue), and endemic syphilis (ssp. endemicum) in humans. Nonhuman primates have also been reported to be infected with the bacterium with equally versatile clinical manifestations, from severe skin ulcerations to asymptomatic. At present all simian strains are closely related to human yaws-causing strains, an important consideration for yaws eradication. We tested clinically healthy Guinea baboons (Papio papio) at Parc National Niokolo Koba in south eastern Senegal for the presence of anti-T. pallidum antibodies. Since T. pallidum infection in this species was identified 50 years ago, and there has been no attempt to treat non-human primates for infection, it was hypothesized that a large number of West African baboons are still infected with simian strains of the yaws-bacterium. All animals were without clinical signs of treponematoses, but 18 of 20 (90%) baboons tested positive for antibodies against T. pallidum based on treponemal tests. Yet, Guinea baboons seem to develop no clinical symptoms, though it must be assumed that infection is chronic or comparable to the latent stage in human yaws infection. The non-active character is supported by the low anti-T. pallidum serum titers in Guinea baboons (median = 1:2,560) versus serum titers that are found in genital-ulcerated olive baboons with active infection in Tanzania (range of medians among the groups of initial, moderate, and severe infected animals = 1:15,360 to 1:2.097e+7). Our findings provide evidence for simian infection with T. pallidum in wild Senegalese baboons. Potentially, Guinea baboons in West Africa serve as a natural reservoir for human infection, as the West African simian strain has been shown to cause sustainable yaws infection when inoculated into humans. The present study pinpoints an area where further research is needed to support the currently on-going second WHO led yaws eradication campaign with

  18. Transcervical administration of polidocanol foam prevents pregnancy in female baboons.

    Science.gov (United States)

    Jensen, Jeffrey T; Hanna, Carol; Yao, Shan; Thompson, Emily; Bauer, Cassondra; Slayden, Ov D

    2016-11-01

    Our objective was to conduct a pilot study to determine if transcervical administration of polidocanol foam (PF) with or without doxycycline or benzalkonium chloride (BZK) would prevent pregnancy in baboons. In study phase 1, adult cycling baboons underwent a hysterosalpingogram to evaluate tubal patency prior to transcervical infusion of 20 mL of 5% PF followed by 1 mL of saline containing 100 mg doxycycline (5%/doxy; n=5), 3% PF plus doxycycline (3%/doxy; n=4), 3% PF with 0.01% BZK (3%/BZK; n=4) or no additional treatment (control; n=9). Immediately following treatment, animals received intramuscular depot medroxyprogesterone acetate (DMPA, 2 mg/kg) to suppress cyclicity during healing and were then socially housed with males of proven fertility. The primary outcome was pregnancy within six cycles of resumption of menses (efficacy phase 1). During study phase 2, PF-treated females from study phase 1 contributed additional cycles (6-8) of exposure (efficacy phase 2), and 5 control females who had recovered from medical abortion (after study phase 1 pregnancy) were subsequently treated with 5% PF (with DMPA) and exposed to breeding (efficacy phase 1; n=3 six cycles, n=2 five cycles). All females resumed normal menstrual cycles and mating activity after DMPA. During efficacy phase 1, 7/9 (78%) control females became pregnant. In contrast, fewer pregnancies occurred in PF-treated females: 5% PF 0/5 (0%), 5%/doxy 1/5 (20%), 3%/doxy 1/4 (25%) and 3%/BZK 1/4 (25%). During efficacy phase 2, only one additional pregnancy occurred (3%/BZK). A single transcervical treatment with 5% PF prevented pregnancy in most baboons. Cotreatment with doxycycline or BZK did not improve results. Transcervical intrauterine administration of PF resulted in a high rate of tubal occlusion with prevention of pregnancy; refinements are needed to increase the contraceptive rate following a single treatment to near 100%. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights

  19. Bioartificial Liver Support

    Directory of Open Access Journals (Sweden)

    Vincent G Bain

    2001-01-01

    Full Text Available Bioartificial liver support has been increasingly the focus of both basic and clinical research in an attempt to replicate the multiplicity of normal liver function. The concept is attractive because, if it is effective, patients with acute liver failure may be supported until native liver regeneration occurs or, by optimizing their condition, until liver transplantation is possible. Current bioartificial liver support systems utilize primary porcine hepatocytes or transformed human hepatocytes, which are housed within a bioreactor, through which the patient's blood or plasma is pumped in an extracorporeal circuit. The optimal source for the hepatocytes is an area of debate; however, a genetically engineered cell line may provide optimal function. Novel three-dimensional matrices that anchor the hepatocytes are being designed to mimic architectural features of the normal liver. Large multicentre, randomized, controlled trials are ongoing following several pilot studies. Serious side effects such as hemodynamic instability and immune reactions have been infrequent. Much controversy, however, surrounds the issue of possible transmission of pig endogenous retrovirus to humans, and current trials are being carefully monitored. Bioartificial liver support is a promising technology, and the results of current and planned studies are awaited with great interest.

  20. VIP innervation: sharp contrast in fetal sheep and baboon adrenal glands suggests differences in developmental regulation.

    Science.gov (United States)

    Berghorn, K A; Li, C; Nathanielsz, P W; McDonald, T J

    2000-09-22

    Immunocytochemical technique and light microscopy were used to ascertain the relationship between vasoactive intestinal polypeptide (VIP) and tyrosine hydroxylase in fetal sheep and fetal baboon adrenal cortices and medullae at 85% of gestation. VIP immunostaining was extremely robust in fetal sheep adrenal cortical neurofibers and cells while weak in fibers and nonexistent in cells of fetal baboon. Also, tyrosine hydroxylase-immunopositive cells, present throughout the adrenal cortices of both fetal sheep and baboons, were heavily innervated by VIP-immunoreactive neurofibers in fetal sheep, but not in fetal baboons. Adrenal cortical VIP-immunopositive fibers occurred in greater (Psection (127.85+/-5.16 vs. 74.53+/-4.93 microm). VIP immunogenicity in cells (ganglion and chromaffin) and fibers was robust in fetal adrenal medulla of sheep while nonexistent in baboons. VIP fibers in fetal sheep medulla were smaller in diameter compared to fetal sheep cortex (1.22+/-0.13 vs. 2.93+/-0.34 microm, Pmedullary neurofibers derive primarily from extrinsic sources while cortical fibers arise from cortical ganglion cells. We conclude that at 85% of gestation the potential for VIP neural control of paracrine (e.g., glucocorticoid/catecholamine) interactions in both adrenal cortex and medulla is much greater in fetal sheep compared to fetal baboons.

  1. Age Effects on Transfer Index Performance and Executive Control in Baboons (Papio papio

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    Elodie eBonté

    2014-03-01

    Full Text Available Reversal performance in the transfer index (TI task is known to improve from prosimians to apes, suggesting that this task is a marker of cognitive evolution within the primate taxa (Rumbaugh, 1970. However, the cognitive processes recruited by this task remain unclear. In the present study, 19 socially-housed baboons (Papio papio from 1.6 to 14.3 years were tested on a computerized version of the TI task, using an automated self-testing procedure. Age was a significant factor in the level of success, with the younger baboons outperforming the adults. The younger baboons also learned the pre-reversal discrimination faster and improved their post-reversal performance more rapidly than adult baboons. As the same baboons had been tested in previous studies on inhibitory control and cognitive flexibility tasks, comparison across tasks provide indicators of the underlying cognitive processes. Age variations in performance were similar between the TI task and in an adaptation of the Wisconsin Card Sorting Task measuring cognitive flexibility (Bonté, Flemming and Fagot, 2011. This contrasts previous results from a task requiring motor inhibitory control (Fagot, Bonté and Hopkins, 2013. Therefore, these findings suggest that cognitive flexibility was a central component of the cognitive system that evolved within nonhuman primates. They also implicate a decline in executive control with age that begins during early adulthood in the baboon species.

  2. Rodent models of ischemic stroke lack translational relevance... are baboon models the answer?

    Science.gov (United States)

    Kwiecien, Timothy D; Sy, Christopher; Ding, Yuchuan

    2014-05-01

    Rodent models of ischemic stroke are associated with many issues and limitations, which greatly diminish the translational potential of these studies. Recent studies demonstrate that significant differences exist between rodent and human ischemic stroke. These differences include the physical characteristics of the stroke, as well as changes in the subsequent inflammatory and molecular pathways following the acute ischemic insult. Non-human primate (NHP) models of ischemic stroke, however, are much more similar to humans. In addition to evident anatomical similarities, the physiological responses that NHPs experience during ischemic stroke are much more applicable to the human condition and thus make it an attractive model for future research. The baboon ischemic stroke model, in particular, has been studied extensively in comparison to other NHP models. Here we discuss the major shortcomings associated with rodent ischemic stroke models and provide a comparative overview of baboon ischemic stroke models. Studies have shown that baboons, although more difficult to obtain and handle, are more representative of ischemic events in humans and may have greater translational potential that can offset these deficiencies. There remain critical issues within these baboon stroke studies that need to be addressed in future investigations. The most critical issue revolves around the size and the variability of baboon ischemic stroke. Compared to rodent models, however, issues such as these can be addressed in future studies. Importantly, baboon models avoid many drawbacks associated with rodent models including vascular variability and inconsistent inflammatory responses - issues that are inherent to the species and cannot be avoided.

  3. DSCR9 gene simultaneous expression in placental, testicular and renal tissues from baboon (papio hamadryas

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    Rodriguez-Sanchez Irám

    2012-06-01

    Full Text Available Abstract Background In 2002 Takamatsu and co-workers described the human DSCR9 gene and observed that it was transcriptionally active in human testicular tissue, but no protein was identified as a product of this transcript. Similar results were obtained in chimpanzee tissue. This gene has not been detected in species other than primates, suggesting that DSCR9 is exclusively found in these mammals. Results We report evidence of DSCR9 expression in placenta, testis and kidney of baboon (Papio hamadryas. We used primers specific for DSCR9 to amplify transcripts through reverse transcription (RT coupled to polymerase chain reaction (PCR. Furthermore, PCR was used to amplify the complete DSCR9 gene from genomic DNA from three baboons. We amplified and sequenced five overlapping segments that were assembled into the 3284 bp baboon DSCR9 gene, including the putative promoter and the entire transcriptional unit (5'-UTR, CDS and 3'-UTR. Conclusions The baboon DSCR9 gene is highly similar to the human counterpart. The isolated transcripts from baboon tissues (placenta, testis and kidney of three different baboons correspond to the human orthologous gene.

  4. Unusually high predation on chacma baboons (Papio ursinus) by female leopards (Panthera pardus) in the Waterberg Mountains, South Africa.

    Science.gov (United States)

    Jooste, E; Pitman, R T; van Hoven, W; Swanepoel, L H

    2012-01-01

    Leopards do not preferentially favour baboons as prey, but they are considered the primary predators of baboons across Africa. Even in areas where baboons are abundant, their contribution to leopard diet seldom exceeds 5% of biomass. It is suggested that the extreme aggressiveness of baboons, group vigilance and their high mobility when escaping may limit leopard predation. Male baboons are particularly aggressive, and retaliation often leads to the death of the leopard. However, evidence suggests that leopards may learn to catch and kill certain dangerous prey. This study reports predation on chacma baboons by 3 female leopards on a private game reserve in the Waterberg Mountains of South Africa. Potential leopard feeding sites were identified using global positioning system (GPS) location clusters obtained from GPS collars. Over a 5-month period, we investigated 200 potential leopard feeding sites and located 96 leopard feeding/kill sites. Baboons constituted 18.7% of the leopards' biomass intake. The majority of baboons preyed upon were adults and 70% of the kills were diurnal. In terms of the measured variables, there were no significant differences in the way the leopards preyed upon baboons, compared to the rest of the prey species.

  5. Social networks predict gut microbiome composition in wild baboons.

    Science.gov (United States)

    Tung, Jenny; Barreiro, Luis B; Burns, Michael B; Grenier, Jean-Christophe; Lynch, Josh; Grieneisen, Laura E; Altmann, Jeanne; Alberts, Susan C; Blekhman, Ran; Archie, Elizabeth A

    2015-01-01

    Social relationships have profound effects on health in humans and other primates, but the mechanisms that explain this relationship are not well understood. Using shotgun metagenomic data from wild baboons, we found that social group membership and social network relationships predicted both the taxonomic structure of the gut microbiome and the structure of genes encoded by gut microbial species. Rates of interaction directly explained variation in the gut microbiome, even after controlling for diet, kinship, and shared environments. They therefore strongly implicate direct physical contact among social partners in the transmission of gut microbial species. We identified 51 socially structured taxa, which were significantly enriched for anaerobic and non-spore-forming lifestyles. Our results argue that social interactions are an important determinant of gut microbiome composition in natural animal populations-a relationship with important ramifications for understanding how social relationships influence health, as well as the evolution of group living.

  6. Cumulative early life adversity predicts longevity in wild baboons.

    Science.gov (United States)

    Tung, Jenny; Archie, Elizabeth A; Altmann, Jeanne; Alberts, Susan C

    2016-04-19

    In humans and other animals, harsh circumstances in early life predict morbidity and mortality in adulthood. Multiple adverse conditions are thought to be especially toxic, but this hypothesis has rarely been tested in a prospective, longitudinal framework, especially in long-lived mammals. Here we use prospective data on 196 wild female baboons to show that cumulative early adversity predicts natural adult lifespan. Females who experience ≥3 sources of early adversity die a median of 10 years earlier than females who experience ≤1 adverse circumstances (median lifespan is 18.5 years). Females who experience the most adversity are also socially isolated in adulthood, suggesting that social processes partially explain the link between early adversity and adult survival. Our results provide powerful evidence for the developmental origins of health and disease and indicate that close ties between early adversity and survival arise even in the absence of health habit and health care-related explanations.

  7. Baboons' response speed is biased by their moods.

    Directory of Open Access Journals (Sweden)

    Yousri Marzouki

    Full Text Available The affect-as-information hypothesis (e.g., Schwarz & Clore, 2003, predicts that the positive or negative valence of our mood differentially affects our processing of the details of the environment. However, this hypothesis has only been tested with mood induction procedures and fairly complex cognitive tasks in humans. Here, six baboons (Papio papio living in a social group had free access to a computerized visual search task on which they were over-trained. Trials that immediately followed a spontaneously expressed emotional behavior were analyzed, ruling out possible biases due to induction procedures. RTs following negatively valenced behaviors are slower than those following neutral and positively valenced behaviors, respectively. Thus, moods affect the performance of nonhuman primates tested in highly automatized tasks, as it does in humans during tasks with much higher cognitive demands. These findings reveal a presumably universal and adaptive mechanism by which moods influence performance in various ecological contexts.

  8. Genetic integration of molar cusp size variation in baboons

    Science.gov (United States)

    Koh, Christina; Bates, Elizabeth; Broughton, Elizabeth; Do, Nicholas T.; Fletcher, Zachary; Mahaney, Michael C.; Hlusko, Leslea J.

    2010-01-01

    Many studies of primate diversity and evolution rely on dental morphology for insight into diet, behavior, and phylogenetic relationships. Consequently, variation in molar cusp size has increasingly become a phenotype of interest. In 2007 we published a quantitative genetic analysis of mandibular molar cusp size variation in baboons. Those results provided more questions than answers, as the pattern of genetic integration did not fit predictions from odontogenesis. To follow up, we expanded our study to include data from the maxillary molar cusps. Here we report on these later analyses, as well as inter-arch comparisons with the mandibular data. We analyzed variation in two-dimensional maxillary molar cusp size using data collected from a captive pedigreed breeding colony of baboons, Papio hamadryas, housed at the Southwest National Primate Research Center. These analyses show that variation in maxillary molar cusp size is heritable and sexually dimorphic. We also estimated additive genetic correlations between cusps on the same crown, homologous cusps along the tooth row, and maxillary and mandibular cusps. The pattern for maxillary molars yields genetic correlations of one between the paracone-metacone and protocone-hypocone. Bivariate analyses of cuspal homologues on adjacent teeth yield correlations that are high or not significantly different from one. Between dental arcades, the non-occluding cusps consistently yield high genetic correlations, especially the metaconid-paracone and metaconid-metacone. This pattern of genetic correlation does not immediately accord with the pattern of development and/or calcification, however these results do follow predictions that can be made from the evolutionary history of the tribosphenic molar. PMID:20034010

  9. Hepatic dysfunction contributes to coagulation disturbances in patients undergoing whole body hyperthermia by use of extracorporeal circulation.

    Science.gov (United States)

    Worel, Nina; Knöbl, Paul; Karanikas, Georgios; Fuchs, Eva-Maria; Bojic, Andja; Brodowicz, Thomas; Jilma, Petra; Zielinski, Christoph C; Köstler, Wolfgang J; Locker, Gottfried J

    2014-09-01

    This phase I study was performed to evaluate coagulation alterations during extracorporeal circulation (ECC) induced whole body hyperthermia (WBHT) in 12 patients with advanced soft tissue sarcomas. To distinguish between effects of normothermic ECC and ECC-WBHT, blood samples were drawn at different time points: at baseline, after 30 min on normothermic ECC, at the end of the heating period, and 24 h and 7 days thereafter. Standard coagulation tests, coagulation factors, thrombelastography,platelets and reticulated platelets, liver enzymes, and scintigraphic platelet imaging were performed. Normothermic ECC resulted in coagulation alterations most likely due to systemic anticoagulation. Induction of hyperthermia caused thrombocytopenia, increased fibrin degradation products,prolonged clotting times, alteration in coagulation factors, and increased liver enzymes. The majority of these effects was most pronounced 24 h after ECC-WBHT. In addition, late liver sequestration of platelets was demonstrated in scintigraphic imaging at that time point. Temporal correlation between hemostatic alterations and elevation in liver enzymes leads to the assumption that liver impairment might play a crucial role in coagulation disturbances observed during ECC-WBHT and thereafter, thus strongly supported by liver sequestration of platelets.Therefore a close monitoring of hepatic derived coagulation alterations in patients undergoing extracorporeal whole body hypothermia is warranted.

  10. Extracorporeal life support in pediatric cardiac patients

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    Matteo Di NARDO

    2016-10-01

    Full Text Available Extracorporeal Life Support (ECLS is a valuable tool in the management of neonates and older children with severe cardiac or respiratory failure. In this review, we focus on ECLS when used for neonatal and pediatric cardiac disease. Strict selection of patients and timely deployment are necessary to optimize outcomes. Although every attempt should be made to deploy ECLS urgently rather than emergently, extracorporeal cardiopulmonary resuscitation (ECPR is being increasingly used and reasonable survival rates have been achieved after initiation of ECLS during active compressions of the chest following in-hospital cardiac arrest. Contraindications to ECLS are falling over time, although lethal chromosomal abnormalities, severe irreversible brain injury, and extremely low gestational age and weight (<32 weeks gestation or <1.5 kg remain firm contraindications.

  11. Extracorporeal treatment for tricyclic antidepressant poisoning

    DEFF Research Database (Denmark)

    Yates, Christopher; Galvao, Tais; Sowinski, Kevin M

    2014-01-01

    The Extracorporeal Treatments In Poisoning (EXTRIP) workgroup was formed to provide recommendations on the use of extracorporeal treatments (ECTR) in poisoning. Here, the workgroup presents its results for tricyclic antidepressants (TCAs). After an extensive literature search, using a predefined...... methodology, the subgroup responsible for this poison reviewed the articles, extracted the data, summarized findings, and proposed structured voting statements following a predetermined format. A two-round modified Delphi method was chosen to reach a consensus on voting statements and RAND...... yielding a very low quality of evidence for all recommendations. Data on 108 patients, including 12 fatalities, were abstracted. The workgroup concluded that TCAs are not dialyzable and made the following recommendation: ECTR is not recommended in severe TCA poisoning (1D). The workgroup considers...

  12. Extracorporeal treatment for valproic acid poisoning

    DEFF Research Database (Denmark)

    Ghannoum, Marc; Laliberté, Martin; Nolin, Thomas D

    2015-01-01

    BACKGROUND: The EXtracorporeal TReatments In Poisoning (EXTRIP) workgroup presents its systematic review and clinical recommendations on the use of extracorporeal treatment (ECTR) in valproic acid (VPA) poisoning. METHODS: The lead authors reviewed all of the articles from a systematic literature....... The workgroup concluded that VPA is moderately dialyzable (level of evidence = B) and made the following recommendations: ECTR is recommended in severe VPA poisoning (1D); recommendations for ECTR include a VPA concentration > 1300 mg/L (9000 μmol/L)(1D), the presence of cerebral edema (1D) or shock (1D...... 50 and 100 mg/L (350-700 μmol/L)(2D). Intermittent hemodialysis is the preferred ECTR in VPA poisoning (1D). If hemodialysis is not available, then intermittent hemoperfusion (1D) or continuous renal replacement therapy (2D) is an acceptable alternative. CONCLUSIONS: VPA is moderately dialyzable...

  13. Early Extracorporeal Detoxification after Cardiosurgical Interventions

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    G. P. Plotnikov

    2009-01-01

    Full Text Available Objective: to substantiate a need for early use of extracorporeal homeostatic correction techniques during cardiosurgical intensive care. Subjects and methods: A non-randomized study was conducted in 63 cardiosurgical patients with postoperatively evolving multiple organ dysfunction. The clinical efficiency and economic expediency of the early initiation of homeostatic correction were estimated by continuous low-flow venovenous hemofiltration on a Prisma apparatus. Results. The study has demonstrated the advantages of early (within the 36-hour postoperative period initiation of a procedure by the time of organ dysfunction recovery, the length of stay on a resuscitation bed, and pharmacoeconomic indices. Conclusion. The early (at the stage of dysfunction, until hemostasis becomes stable and in the absence of drainage volume losses initiation of hemofiltration in the development of multiple organ dysfunction after surgical interventions has been clinically and economically warranted. Key words: extracorporeal homeostatic correction, multiple organ dysfunction, cardiac surgery.

  14. Experimental study of bioartificial liver with cultured human liver cells

    Institute of Scientific and Technical Information of China (English)

    1999-01-01

    AIM To establish an extracorporeal bioartificial liver support system (EBLSS) using cultured human liver cells and to study its support effect for fulminant hepatic failure (FHF).METHODS The liver support experiment of EBLSS consisting of aggregates cultured human liver cells, hollow fiber bioreactor, and circulation unit was carried out in dizhepatic dogs.RESULTS The viability of isolated hepatocytes and nonparenchymal liver cells reached 96%. These cells were successfully cultured as multicellular spheroids with synthetic technique. The typical morphological appearance was retained up to the end of the artificial liver experiment. Compared with the control dogs treated with EBLSS without liver cells, the survival time of artificial liver support dogs was significantly prolonged. The changes of blood pressure, heart rate and ECG were slow. Both serum ammonia and lactate levels were significantly lowered at the 3rd h and 5th h. In addition, a good viability of human liver cells was noted after 5 h experiment.CONCLUSION EBLSS playing a metabolic role of cultured human hepatocytes, is capable of compensating the function of the liver, and could provide effective artificial liver support and therapy for patients with FHF.

  15. [Ureterorenoscopy combined with extracorporeal shockwave lithotripsy].

    Science.gov (United States)

    González Cabrera, L A; Oro Ortiz, J

    1989-01-01

    In May 1986, extracorporeal shock wave lithotripsy and endourologic procedures became available in the treatment of lithiasis at the "Hermanos Ameijeiras" Hospital. The present study describes our experience and the results achieved during a 12-month period using endourologic procedures. During this period 65 URS procedures were performed to treat post-ESWL ureteral obstruction, and 22 to push the stone up to the kidney for subsequent ESWL treatment.

  16. Intracellular maturation of apolipoprotein[a] and assembly of lipoprotein[a] in primary baboon hepatocytes.

    Science.gov (United States)

    White, A L; Rainwater, D L; Lanford, R E

    1993-03-01

    The glycoprotein apolipoprotein[a] (apo[a]) is present in plasma at highly variable concentrations and appears as a number of genetically determined size isoforms (400-800 kDa), disulfide linked to apoB-100 in low density lipoprotein to produce lipoprotein [a](Lp[a]). Apo[a] is synthesized by the liver, but the site of association of apo[a] and apoB and factors that regulate its production are unknown. To examine the morphogenesis of the Lp[a] particle, baboon hepatocytes expressing a single, low molecular weight isoform of apo[a] were labeled with [35S]cysteine and methionine, and apo[a] was analyzed by immunoprecipitation and SDS-PAGE. Steady-state labeling revealed two molecular weight forms of apo[a] inside the cell. Only the large form was recovered from the culture medium. Pulse-chase studies and endoglycosidase treatment revealed that the lower molecular weight form of apo[a] represented a precursor with a prolonged residence time in the endoplasmic reticulum or an early Golgi compartment, after which it was processed to the mature form. A proportion of the mature form of apo[a] was rapidly secreted after synthesis, whereas the remainder had a prolonged residence time in a late Golgi compartment. In all experiments, apoB co-precipitated with apo[a] from the culture medium, but not from cell lysates. Density gradient ultracentrifugation and immunoblot analysis revealed that the majority of apo[a] was secreted into the medium in a free form, suggesting that the association between apo[a] and apoB occurred after secretion. Regulation of the movement of apo[a] between intracellular compartments may be one mechanism by which the plasma levels of Lp[a] are influenced.

  17. [Veno-venous extracorporeal oxygenation and veno-arterial extracorporeal oxygenation. Questions, answers].

    Science.gov (United States)

    Isetta, C; Lebreton, G; Janot, N; Prommenschenkel, M; Rilos, Z; Roques, F; Longrois, D

    2014-04-01

    A round table, organized by the French Society of Perfusion (Sofraperf) at the French national congress on extracorporeal circulations (Perfusion 2013), was attended by perfusionists, anaesthesiologists, intensivists and surgeons around the theme of respiratory veno-venous support and veno-arterial circulatory support with extracorporeal oxygenation in intensive care units. The debate was conducted in a participatory manner by bi-directional questions-answers session between moderators and assistance. The authors report management of this type of therapy that is not perfectly homogeneous, supported on literature data. Cannulae, cannulation, circuit, oxygenator, anticoagulation, control, surveillance, weaning are subject to paragraphs with defined entry whose contents are mutually enriching.

  18. Sex differences in the acoustic structure of vowel-like grunt vocalizations in baboons and their perceptual discrimination by baboon listeners

    Science.gov (United States)

    Rendall, Drew; Owren, Michael J.; Weerts, Elise; Hienz, Robert D.

    2004-01-01

    This study quantifies sex differences in the acoustic structure of vowel-like grunt vocalizations in baboons (Papio spp.) and tests the basic perceptual discriminability of these differences to baboon listeners. Acoustic analyses were performed on 1028 grunts recorded from 27 adult baboons (11 males and 16 females) in southern Africa, focusing specifically on the fundamental frequency (F0) and formant frequencies. The mean F0 and the mean frequencies of the first three formants were all significantly lower in males than they were in females, more dramatically so for F0. Experiments using standard psychophysical procedures subsequently tested the discriminability of adult male and adult female grunts. After learning to discriminate the grunt of one male from that of one female, five baboon subjects subsequently generalized this discrimination both to new call tokens from the same individuals and to grunts from novel males and females. These results are discussed in the context of both the possible vocal anatomical basis for sex differences in call structure and the potential perceptual mechanisms involved in their processing by listeners, particularly as these relate to analogous issues in human speech production and perception.

  19. Schistosoma mansoni: parasitology and immunology of baboons vaccinated with irradiated cryopreserved schistosomula

    Energy Technology Data Exchange (ETDEWEB)

    Damian, R.T.; Powell, M.R.; Roberts, M.L. (Georgia Univ., Athens (USA). Dept. of Zoology); Clark, J.D. (Georgia Univ., Athens (USA). Lab. Animal Medicine); Stirewalt, M.A.; Lewis, F.A. (Biomedical Research Inst., Rockville, MD (USA))

    1985-06-01

    Young baboons (Papio cynocephalus) were vaccinated with ..gamma..-irradiated (500 Gy) cryopreserved Puerto Rican strain schistosomula of S. mansoni. Protection against heterologous, normal Kenyan Strain S. mansoni challenge infection was erratic and partial; and two putative correlates of immunity, reduced worm fecundity and change in worm location (anterior shift) were not observed. However, immunization of baboons with this vaccine resulted in a stimulated immune system. Both cellular and humoral anamnesis were demonstrable in vaccinated-challenged baboons. Schistosome infection-associated IgM hypergammaglobulinemia was also greatly reduced in vaccinated-challenged baboons. However IgG antibodies to adult, egg, and cercarial antigens were increased after challenge infection in preimmunized baboons. Vaccination appears to have resulted in a redirection of the immune system into anti-parasite channels, but this more specific immune response was insufficient to confer good protection against challenge infection in this experiment. The dampening effect of the vaccine on the hypergammaglobulinemia of schistosomiasis is another candidate for a possible ''anti-pathogenesis'' effect of irradiated schistosome larval vaccines.

  20. Bomb-spike dating of a mummified baboon in Ludwig Cave, Namibia

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    Hodgins Greg

    2007-01-01

    Full Text Available In 1982 a mummified adult female baboon was discovered on a ledge in Ludwig Cave in Namibia. A toe bone was removed for dating in July 1995. AMS radiocarbon dating of bone collagen, tendon, and skin indicates a post-modern age. Application of the atomic bomb-spike calibration curve suggests death in late 1977 and an age at death of around 19 years. Baboons roost in the cave and the mummified female, along with a mummified juvenile male discovered in 2002 and three rotting corpses discovered in 1995, were probably chased by other baboons or by leopards down a ca. 6 m drop during the rainy season, and were unable to climb the steep and very slippery slope to escape. The large number of baboons trapped in the cave in less than 20 years, and mummification of two individuals on dry, dusty ledges in the cave, may explain why large numbers of baboon skeletons have been discovered in ancient bone breccias (up to 4 Ma old in a number of caves throughout Southern Africa.

  1. Comparing responses of four ungulate species to playbacks of baboon alarm calls.

    Science.gov (United States)

    Kitchen, Dawn M; Bergman, Thore J; Cheney, Dorothy L; Nicholson, James R; Seyfarth, Robert M

    2010-11-01

    A growing body of evidence suggests that a wide range of animals can recognize and respond appropriately to calls produced by other species. Social learning has been implicated as a possible mechanism by which heterospecific call recognition might develop. To examine whether familiarity and/or shared vulnerability with the calling species might influence the ability of sympatric species to distinguish heterospecific alarm calls, we tested whether four ungulate species (impala: Aepyceros melampus; tsessebe: Damaliscus lunatus; zebra: Equus burchelli; wildebeest: Connochaetes taurinus) could distinguish baboon (Papio hamadryas ursinus) alarm calls from other loud baboon calls produced during intra-specific aggressive interactions ('contest' calls). Overall, subjects' responses were stronger following playback of alarm calls than contest calls. Of the species tested, impala showed the strongest responses and the greatest difference in composite response scores, suggesting they were best able to differentiate call types. Compared with the other ungulate species, impala are the most frequent associates of baboons. Moreover, like baboons, they are susceptible to both lion and leopard attacks, whereas leopards rarely take the larger ungulates. Although it seems possible that high rates of association and/or shared vulnerability may influence impala's greater ability to distinguish among baboon call types, our results point to a stronger influence of familiarity. Ours is the first study to compare such abilities among several community members with variable natural histories, and we discuss future experiments that would more systematically examine development of these skills in young ungulates.

  2. Performance of juvenile baboons on neuropsychological tests assessing associative learning, motivation and attention.

    Science.gov (United States)

    Zürcher, Nicole R; Rodriguez, Jesse S; Jenkins, Sue L; Keenan, Kate; Bartlett, Thad Q; McDonald, Thomas J; Nathanielsz, Peter W; Nijland, Mark J

    2010-05-15

    The CANTAB (Cambridge Neuropsychological Test Automated Battery), a system developed for human neuropsychological testing, has previously been used to assess cognitive function in two species of nonhuman primates, common marmoset monkeys and rhesus macaques. We describe the application of the system to the juvenile baboon, a nonhuman primate species offering specific investigative advantages. Juvenile baboons were trained and tested on a progressive ratio task to assess motivation, simple discrimination and simple reversal tasks to assess associative learning, and intra- and extra-dimensional set-shifting tasks to assess selective attention and attentional set-shifting, respectively. Study subjects were 8 juvenile baboons (Papio sp.), 4 females and 4 males aged 3.0+/-0.1 (mean+SEM) years and weight 8.2+/-0.4 kg. All baboons were easily trained, readily learned the neuropsychological tests and exhibited a stable performance. Applying a method such as the CANTAB has significant implications for expanding on the translational utility of the baboon in studies of neurodevelopment.

  3. Human infants and baboons show the same pattern of handedness for a communicative gesture.

    Directory of Open Access Journals (Sweden)

    Helene Meunier

    Full Text Available To test the role of gestures in the origin of language, we studied hand preferences for grasping or pointing to objects at several spatial positions in human infants and adult baboons. If the roots of language are indeed in gestural communication, we expect that human infants and baboons will present a comparable difference in their pattern of laterality according to task: both should be more right-hand/left-hemisphere specialized when communicating by pointing than when simply grasping objects. Our study is the first to test both human infants and baboons on the same communicative task. Our results show remarkable convergence in the distribution of the two species' hand biases on the two kinds of tasks: In both human infants and baboons, right-hand preference was significantly stronger for the communicative task than for grasping objects. Our findings support the hypothesis that left-lateralized language may be derived from a gestural communication system that was present in the common ancestor of baboons and humans.

  4. Effect of sodium depletion on peripheral vascular responses to heat stress in baboons.

    Science.gov (United States)

    Proppe, D W

    1987-04-01

    The cutaneous vasodilation and renal vasoconstriction in baboons during environmental heating (EH) appear to be produced predominantly by sympathetic vasoconstrictor withdrawal and activation of the renin-angiotensin system, respectively. Since these mechanisms may be influenced differently by sodium depletion, this study examined the hypothesis that sodium depletion would have a differential effect on cutaneous and renal vascular responses to EH. Sodium depletion was produced in chronically instrumented baboons by placing them on low-salt intake for 8-19 days along with diuretic administration. EH consisted of exposing the baboon to an ambient temperature of 40-42 degrees C until core temperature (Tc) reached 39.8-40.0 degrees C. Both control plasma renin activity (PRA) and the rise in PRA with Tc during EH were considerably larger in sodium-depleted baboons. However, the magnitudes of the progressive increases in iliac vascular conductance (used as an index of hindlimb cutaneous vasodilation) and renal vascular resistance with rising Tc during EH were unaltered by sodium depletion. Therefore, neither cutaneous nor renal vascular responses to EH are influenced by elevated PRA and other changes accompanying sodium depletion in the baboon.

  5. Spontaneous disc degeneration in the baboon model: magnetic resonance imaging and histopathologic correlation.

    Science.gov (United States)

    Platenberg, R C; Hubbard, G B; Ehler, W J; Hixson, C J

    2001-10-01

    Degenerative disc disease is a major source of disability in humans. The baboon model is an excellent natural disease model to study comparable human disease, because baboons are relatively large (adult males 20-26 kg, adult females 12-17 kg), long-lived (30-45 years), well defined, easy to use, and closely related to humans. Published investigations with plain radiographs of disc degeneration in baboons indicated vertebral anatomy and changes that were remarkably similar to those seen in humans, and it would be valuable to determine if magnetic resonance imaging (MRI) and histopathologic evaluation would be useful methods for studying the model, as MRI allows multi-planar visualization of tissues without the use of intravenous contrast and it is superior for evaluating disc hydration, annulus tears, and herniations. The thoracolumbar junctions from 47 randomly selected baboons, ranging in age from 2 weeks to 34 years, were evaluated with MRI and histopathology. Excellent correlation with MRI was observed for changes in disc desiccation, height, and age (P discs seen by MRI were in baboons 14 years of age or older.

  6. S110, a novel decitabine dinucleotide, increases fetal hemoglobin levels in baboons (P. anubis

    Directory of Open Access Journals (Sweden)

    Banzon Virryan

    2010-10-01

    Full Text Available Abstract Background S110 is a novel dinucleoside analog that could have advantages over existing DNA methyltransferase (DNMT inhibitors such as decitabine. A potential therapeutic role for S110 is to increase fetal hemoglobin (HbF levels to treat β-hemoglobinopathies. In these experiments the effect of S110 on HbF levels in baboons and its ability to reduce DNA methylation of the γ-globin gene promoter in vivo were evaluated. Methods The effect of S110 on HbF and γ-globin promoter DNA methylation was examined in cultured human erythroid progenitors and in vivo in the baboon pre-clinical model. S110 pharmacokinetics was also examined in the baboon model. Results S110 increased HbF and reduced DNA methylation of the γ-globin promoter in human erythroid progenitors and in baboons when administered subcutaneously. Pharmacokinetic analysis was consistent with rapid conversion of S110 into the deoxycytosine analog decitabine that binds and depletes DNA. Conclusion S110 is rapidly converted into decitabine, hypomethylates DNA, and induces HbF in cultured human erythroid progenitors and the baboon pre-clinical model.

  7. Can low-intensity extracorporeal shockwave therapy improve erectile dysfunction?

    DEFF Research Database (Denmark)

    Olsen, Anne B; Persiani, Marie; Boie, Sidsel

    2015-01-01

    OBJECTIVE: The aim of this study was to investigate whether low-intensity extracorporeal shockwave therapy (LI-ESWT) can be used as a treatment for men with erectile dysfunction of organic origin. MATERIALS AND METHODS: This prospective, randomized, blinded, placebo-controlled study included 112 ...... are needed. KEYWORDS: Erectile dysfunction; extracorporeal shockwave; penis...

  8. Unfocused Extracorporeal Shock Waves Induce Anabolic Effects in Rat Bone

    NARCIS (Netherlands)

    O.P. van der Jagt (Olav); T.M. Piscaer (Tom); W. Schaden (Wolfgang); J. Li; N. Kops (Nicole); H. Jahr (Holger); J.C. van der Linden (Jacqueline); J.H. Waarsing (Jan); J.A.N. Verhaar (Jan); M. de Jong (Marion); H.H. Weinans (Harrie)

    2011-01-01

    textabstractAbstract. BACKGROUND: Extracorporeal shock waves are known to stimulate the differentiation of mesenchymal stem cells toward osteoprogenitors and induce the expression of osteogenic-related growth hormones. The aim of this study was to investigate if and how extracorporeal shock waves af

  9. Unfocused Extracorporeal Shock Waves Induce Anabolic Effects in Rat Bone

    NARCIS (Netherlands)

    O.P. van der Jagt (Olav); T.M. Piscaer (Tom); W. Schaden (Wolfgang); J. Li; N. Kops (Nicole); H. Jahr (Holger); J.C. van der Linden (Jacqueline); J.H. Waarsing (Jan); J.A.N. Verhaar (Jan); M. de Jong (Marion); H.H. Weinans (Harrie)

    2011-01-01

    textabstractAbstract. BACKGROUND: Extracorporeal shock waves are known to stimulate the differentiation of mesenchymal stem cells toward osteoprogenitors and induce the expression of osteogenic-related growth hormones. The aim of this study was to investigate if and how extracorporeal shock waves

  10. Extracorporeal shock wave lithotripsy of biliary and pancreatic stones

    NARCIS (Netherlands)

    R. den Toom (Rene)

    1993-01-01

    textabstractThe aim of the study was to answer the following questions: Is extracorporeal shock wave lithotripsy for gallbladder stones a safe and effective therapy? (Chapter 2) Is simultaneous treatment with extracorporeal shock wave lithotripsy and the solvent methyl te.rt-butyl ether feasible, sa

  11. Extracorporeal membrane oxygenation as an alternative to ventilation.

    Science.gov (United States)

    Malagon, Ignacio; Greenhalgh, Donna

    2013-02-01

    Following the recent H1N1 epidemic, there has been renewed interest in using extracorporeal membrane oxygenation (ECMO) as a treatment for acute respiratory failure. Currently, following the advances in technology, ECMO is now recommended as a definitive treatment for acute respiratory failure. However, there have been limited randomized trials and cohort studies evaluating this therapy. Currently, results imply that ECMO is superior to conventional ventilation providing lung rest. There is expansion in the indications for ECMO including a bridge to lung transplantation, the use of ECMO in awake patients, liver transplantation, as well as in adult respiratory distress syndrome. This article looks at the current indications and uses. Further studies are warranted to define and validate the role of ECMO, including studying the pharmacodynamics and pharmacokinetics of patients receiving support. The use of sedatives and antibiotics may be required to be changed significantly. If the incidence of intracerebral haemorrhage can be decreased, then in the author's opinion it may become the first-line treatment for acute respiratory failure.

  12. TRANSPLANTATION OF HEPATOCYTES AS THE METHOD OF TREATMENT OF LIVER FAILURE: EXPERIMENTAL AND CLINICAL EXPERIENCE

    Directory of Open Access Journals (Sweden)

    M. Y. Shagidulin

    2010-01-01

    Full Text Available For correction and treatment of liver failure before liver transplantation were proposed severe methods such as: extracorporal devices, transplantation of hepatocytes and implanted tissue-engineering units. The function of healthy hepatocytes presumes to stabilize the state of patients with chronic liver diseases and to wait a donor organ transplantation. In this review the results of experimental and clinical therapy of liver diseases by method of hepatocyte transplantation were summarized. 

  13. Threats to Gelada Baboon (Theropithecus gelada around Debre Libanos, Northwest Shewa Zone, Ethiopia

    Directory of Open Access Journals (Sweden)

    Kassahun Abie

    2016-01-01

    Full Text Available This study was aimed at determining threats to gelada baboon around Debre Libanos, Northwest Shewa Zone, Ethiopia. This was investigated based on questionnaire, informant interview, focus group discussion, and direct observation methods from August 2012 to March 2013. Data were analyzed using descriptive statistics, and responses were compared using chi-square test. Habitat destruction (95%, livestock grazing (91.67%, expansion of agricultural land (88.33%, expansion of invasive species (58.33% in the area that reduces the availability and quality of gelada baboon’s food, inappropriate investment activity (75%, and depredation (66.67% were the major threats to gelada baboons in the study area. All these challenges could cause a short and long-term effect on gelada baboon population size and growth rate.

  14. Male-driven grooming bouts in mixed-sex dyads of Kinda baboons (Papio kindae).

    Science.gov (United States)

    Weyher, Anna H; Phillips-Conroy, Jane E; Fourrier, Marc S; Jolly, Clifford J

    2014-01-01

    The behavior of the Central African Kinda baboon (Papio kindae) is not well documented. Having previously noted distinctive grooming behavior in several Kinda baboon populations, we investigated the topic more systematically in the Kafue National Park, Zambia. We recorded the duration and details of male-female dyadic interactions (approaches, withdrawals and time spent grooming) in the early morning and late afternoon. Such interactions were more often initiated by the male and terminated by the female partner. The male groomed the female more often, and longer, than she groomed him, regardless of the female's reproductive state or the presence of an infant. The bias towards male grooming was stronger in morning than evening interactions. These behaviors, whose function is not immediately obvious, and which are unlike those previously reported in baboons, further exemplify the distinctiveness of the taxon.

  15. A non-Levy random walk in chacma baboons: what does it mean?

    Directory of Open Access Journals (Sweden)

    Cédric Sueur

    Full Text Available The Lévy walk is found from amoebas to humans and has been described as the optimal strategy for food research. Recent results, however, have generated controversy about this conclusion since animals also display alternatives to the Lévy walk such as the Brownian walk or mental maps and because movement patterns found in some species only seem to depend on food patches distribution. Here I show that movement patterns of chacma baboons do not follow a Lévy walk but a Brownian process. Moreover this Brownian walk is not the main process responsible for movement patterns of baboons. Findings about their speed and trajectories show that baboons use metal maps and memory to find resources. Thus the Brownian process found in this species appears to be more dependent on the environment or might be an alternative when known food patches are depleted and when animals have to find new resources.

  16. Population structure and habitat use of baboons (Papio hamadryas ursinus in the Blyde Canyon Nature Reserve

    Directory of Open Access Journals (Sweden)

    A.J. Marais

    2006-12-01

    Full Text Available Baboons are highly intelligent and ecologically flexible animals with attributes that allow them to exploit diverse habitats. As a result of their dietary flexibility they often exploit human habitats, causing damage to crops and forest plantations as well as to human dwellings. In the South African context this has led to baboons being regarded as problem animals and attempted extirpation is the most common approach to the damage they cause. This perception of and attitude toward baboons gives many conservationists cause for concern since all southern African cercopithecine primates are CITES listed and it has not been proven that this strategy is the best long-term solution. As part of a research programme focusing on the damage done by chacma baboons in pine plantations along the Drakensberg escarpment in Mpumalanga, a single troop in the Blyde Canyon Nature Reserve was studied to describe their patterns of habitat use. Vegetation and habitat surveys were conducted within the home range of the troop. The troop was habituated and each member’s activity, location and food items utilised were recorded over a 12 month period. The results of this study indicate that baboons utilised plant communities based on food production and availability rather than size in hectares. The results also indicate that the group size, foraging and food search strategies of this troop resembles that of the Drakensberg troops previously studied. The study troop employs two different forage modes of engagement depending on where they choose to forage while they avoid utilising an easily accessible pine plantation. Due to the troop’s long inter-birth intervals it is likely that the current forestry practice of extirpation may have a negative influence on baboon population viability in these areas.

  17. The Regulation of Proresolving Lipid Mediator Profiles in Baboon Pneumonia by Inhaled Carbon Monoxide

    Science.gov (United States)

    Dalli, Jesmond; Kraft, Bryan D.; Colas, Romain A.; Shinohara, Masakazu; Fredenburgh, Laura E.; Hess, Dean R.; Chiang, Nan; Welty-Wolf, Karen; Choi, Augustine M.; Piantadosi, Claude A.

    2015-01-01

    Strategies for the treatment of bacterial pneumonia beyond traditional antimicrobial therapy have been limited. The recently discovered novel genus of lipid mediators, coined “specialized proresolving mediators” (SPMs), which orchestrate clearance of recruited leukocytes and restore epithelial barrier integrity, have offered new insight into the resolution of inflammation. We performed lipid mediator (LM) metabololipidomic profiling and identification of LMs on peripheral blood leukocytes and plasma from a baboon model of Streptococcus pneumoniae pneumonia. Leukocytes and plasma were isolated from whole blood of S. pneumoniae–infected (n = 5–6 per time point) and control, uninfected baboons (n = 4 per time point) at 0, 24, 48, and 168 hours. In a subset of baboons with pneumonia (n = 3), we administered inhaled carbon monoxide (CO) at 48 hours (200–300 ppm for 60–90 min). Unstimulated leukocytes from control animals produced a proresolving LM signature with elevated resolvins and lipoxins. In contrast, serum-treated, zymosan-stimulated leukocytes and leukocytes from baboons with S. pneumoniae pneumonia produced a proinflammatory LM signature profile with elevated leukotriene B4 and prostaglandins. Plasma from baboons with S. pneumoniae pneumonia also displayed significantly reduced LM–SPM levels, including eicosapentaenoic acid–derived E-series resolvins (RvE) and lipoxins. CO inhalation increased levels of plasma RvE and lipoxins relative to preexposure levels. These results establish the leukocyte and plasma LM profiles biosynthesized during S. pneumoniae pneumonia in baboons and provide evidence for pneumonia-induced dysregulation of these proresolution programs. Moreover, these SPM profiles are partially restored with inhaled low-dose CO and SPM, which may shorten the time to pneumonia resolution. PMID:25568926

  18. Microsomal drug-metabolizing enzymes in the olive baboon (papio anabis)

    DEFF Research Database (Denmark)

    1975-01-01

    1.1. The activity of microsomal drug-metabolizing enzymes—azo reductase, nitroreductase, p-hydroxylation, N-demethylation, O-demethylation, NADPH cytochrome c reductase and cytochrome P P-450—in the olive baboon are lower than in other animal species, e.g. mouse, rat, guinea-pig. 2. 2. The level...... is comparable with the level in man for N-demethylation, azo reductase, O-demethylation and NADPH cytochrome c reductase. 3. 3. The ratio of the activity of the p-hydroxylation as compared with cytochrome P-450 is very similar in baboon and man. 4. 4. Arylsulfatase is localized in the lysosomal fraction...

  19. High Prevalence of Antibodies against the Bacterium Treponema pallidum in Senegalese Guinea Baboons (Papio papio.

    Directory of Open Access Journals (Sweden)

    Sascha Knauf

    Full Text Available The bacterium Treponema pallidum is known to cause syphilis (ssp. pallidum, yaws (ssp. pertenue, and endemic syphilis (ssp. endemicum in humans. Nonhuman primates have also been reported to be infected with the bacterium with equally versatile clinical manifestations, from severe skin ulcerations to asymptomatic. At present all simian strains are closely related to human yaws-causing strains, an important consideration for yaws eradication. We tested clinically healthy Guinea baboons (Papio papio at Parc National Niokolo Koba in south eastern Senegal for the presence of anti-T. pallidum antibodies. Since T. pallidum infection in this species was identified 50 years ago, and there has been no attempt to treat non-human primates for infection, it was hypothesized that a large number of West African baboons are still infected with simian strains of the yaws-bacterium. All animals were without clinical signs of treponematoses, but 18 of 20 (90% baboons tested positive for antibodies against T. pallidum based on treponemal tests. Yet, Guinea baboons seem to develop no clinical symptoms, though it must be assumed that infection is chronic or comparable to the latent stage in human yaws infection. The non-active character is supported by the low anti-T. pallidum serum titers in Guinea baboons (median = 1:2,560 versus serum titers that are found in genital-ulcerated olive baboons with active infection in Tanzania (range of medians among the groups of initial, moderate, and severe infected animals = 1:15,360 to 1:2.097e+7. Our findings provide evidence for simian infection with T. pallidum in wild Senegalese baboons. Potentially, Guinea baboons in West Africa serve as a natural reservoir for human infection, as the West African simian strain has been shown to cause sustainable yaws infection when inoculated into humans. The present study pinpoints an area where further research is needed to support the currently on-going second WHO led yaws eradication

  20. Liver transplant

    Science.gov (United States)

    Hepatic transplant; Transplant - liver; Orthotopic liver transplant; Liver failure - liver transplant; Cirrhosis - liver transplant ... The donated liver may be from: A donor who has recently died and has not had liver injury. This type of ...

  1. Challenges on the road to a multicellular bioartificial liver

    NARCIS (Netherlands)

    Starokozhko, Viktoriia; Groothuis, Geny M M

    2016-01-01

    Over the past years the progress in the development of a bioartificial liver (BAL) as an extracorporeal device or as a tissue engineered transplantable organ has been immense. However, many important BAL characteristics that are necessary to meet clinical demands, have not been sufficiently addresse

  2. Challenges on the road to a multicellular bioartificial liver

    NARCIS (Netherlands)

    Starokozhko, Viktoriia; Groothuis, Geny M M

    2016-01-01

    Over the past years the progress in the development of a bioartificial liver (BAL) as an extracorporeal device or as a tissue engineered transplantable organ has been immense. However, many important BAL characteristics that are necessary to meet clinical demands, have not been sufficiently

  3. Active rehabilitation in a pediatric extracorporeal membrane oxygenation patient.

    Science.gov (United States)

    Zebuhr, Carleen; Sinha, Amit; Skillman, Heather; Buckvold, Shannon

    2014-05-01

    Decreased intensive care unit (ICU) mortality has led to an increase in ICU morbidity. ICU-induced immobilization plays a major role in this morbidity. Recently, ICU mobility has been shown to be safe and effective in adolescent and adult patients. We report the successful rehabilitation of an 8-year-old boy with severe acute respiratory distress syndrome on extracorporeal membrane oxygenation. A child who is critically ill may safely perform active rehabilitation while on venovenous extracorporeal membrane oxygenation. The gains achieved through active rehabilitation and optimal nutrition can facilitate recovery from severe acute respiratory distress syndrome in select pediatric patients on extracorporeal membrane oxygenation.

  4. Proteomics in extracorporeal blood purification and peritoneal dialysis.

    Science.gov (United States)

    Thongboonkerd, Visith

    2010-01-03

    Extracorporeal blood purification and peritoneal dialysis are widely used in renal replacement therapy for patients with end-stage renal disease (ESRD) and acute kidney injury (AKI). Additionally, extracorporeal blood purification can be used also for treatment of non-renal disorders to remove endogenous or exogenous toxins from the blood circulation. Efforts have been made to characterize these toxins removed by diffusion (dialysis), convection (ultrafiltration), and/or adsorption (toxins are adsorbed onto the dialysis membrane and are thus removed) using different types of dialysis membrane. This review summarizes important findings obtained from recent proteomic studies applied to extracorporeal blood purification and peritoneal dialysis in settings of ESRD, AKI and hepatic failure.

  5. Hydroxyethyl starch solution for extracorporeal tissue perfusion.

    Science.gov (United States)

    Taeger, Christian D; Friedrich, Oliver; Drechsler, Caroline; Weigand, Annika; Hobe, Frieder; Geppert, Carol I; Münch, Frank; Birkholz, Torsten; Buchholz, Rainer; Horch, Raymund E; Präbst, Konstantin

    2016-11-04

    In the field of free flap transfer in reconstructive surgery, the trans- or replanted tissue always undergoes cell damage during ischemia to a more or less strong extent. In previous studies we already showed that conserving muscle transplants by means of extracorporeal perfusion over a period of 6 hours by using a crystalloid solution for perfusion. However, we observed significant edema formation. In this study we aimed at reducing the edema formation by using an iso-oncotic colloid as perfusion solution. This way we wanted to evaluate a possible new application of hydroxyl-ethyl starch in an extracorporeal setup to exploit potential benefits of the colloid.Examined parameters include the muscles' functionality with external field stimulation, histological examination and edema formation. Perfused muscles showed a statistically significant higher ability to exert force compared to nonperfused ones. These findings can be confirmed using Annexin V as marker for cell damage, as perfusion of muscle tissue limits damage significantly compared to nonperfused tissue. Substituting the electrolyte perfusion solution with a colloidal one shows the tendency to reduce the edema formation however without statistical significance.

  6. Are there advantages in the use of specific pathogen-free baboons in pig organ xenotransplantation models?

    Science.gov (United States)

    Zhou, Huidong; Iwase, Hayato; Wolf, Roman F; Ekser, Burcin; Ezzelarab, Mohamed; Hara, Hidetaka; White, Gary; Cooper, David K C

    2014-01-01

    Baboons have natural antibodies against pig antigens. We have investigated whether there are differences in anti-non-Gal pig antibody levels between baboons maintained under specific pathogen-free (SPF) conditions and those housed under conventional conditions (non-SPF) that might be associated with improved outcome after pig-to-baboon organ transplantation. Baboons (n = 40) were housed indoors (SPF n = 8) or in indoor/outdoor pens (non-SPF n = 32) in colonies of similar size and structure. Non-SPF colonies harbor a number of pathogens common to non-human primate species, whereas many of these pathogens have been eliminated from the SPF colony. Complete blood cell counts (CBC), blood chemistry, and anti-non-Gal IgM and IgG levels were monitored. There were no significant differences in CBC or blood chemistry between SPF and non-SPF baboons. Anti-non-Gal IgM levels were significantly lower in the SPF baboons than in the non-SPF baboons (MFI 7.1 vs. 8.8, P 20; if these three baboons are omitted, the mean MFIs were 4.8 (SPF) vs. 7.5 (non-SPF) (P xenotransplantation studies as the initial binding of anti-pig IgM to an α1,3-galactosyltransferase gene-knockout pig organ may be less, thus resulting in less complement and/or endothelial cell activation. However, even under identical SPF conditions, an occasional baboon will express a high level of anti-non-Gal IgM, the reason for which remains uncertain.

  7. Heritability of lumbar trabecular bone mechanical properties in baboons.

    Science.gov (United States)

    Havill, L M; Allen, M R; Bredbenner, T L; Burr, D B; Nicolella, D P; Turner, C H; Warren, D M; Mahaney, M C

    2010-03-01

    Genetic effects on mechanical properties have been demonstrated in rodents, but not confirmed in primates. Our aim was to quantify the proportion of variation in vertebral trabecular bone mechanical properties that is due to the effects of genes. L3 vertebrae were collected from 110 females and 46 male baboons (6-32 years old) from a single extended pedigree. Cranio-caudally oriented trabecular bone cores were scanned with microCT then tested in monotonic compression to determine apparent ultimate stress, modulus, and toughness. Age and sex effects and heritability (h(2)) were assessed using maximum likelihood-based variance components methods. Additive effects of genes on residual trait variance were significant for ultimate stress (h(2)=0.58), toughness (h(2)=0.64), and BV/TV (h(2)=0.55). When BV/TV was accounted for, the residual variance in ultimate stress accounted for by the additive effects of genes was no longer significant. Toughness, however, showed evidence of a non-BV/TV-related genetic effect. Overall, maximum stress and modulus show strong genetic effects that are nearly entirely due to bone volume. Toughness shows strong genetic effects related to bone volume and shows additional genetic effects (accounting for 10% of the total trait variance) that are independent of bone volume. These results support continued use of bone volume as a focal trait to identify genes related to skeletal fragility, but also show that other focal traits related to toughness and variation in the organic component of bone matrix will enhance our ability to find additional genes that are particularly relevant to fatigue-related fractures.

  8. Rank and grooming reciprocity among females in a mixed-sex group of captive hamadryas baboons

    NARCIS (Netherlands)

    Leinfelder, I.; Vries, Han de; Deleu, R.; Nelissen, M.

    2001-01-01

    In a mixed-sex, captive group of hamadryas baboons (Papio hamadryas hamadryas) we investigated whether female grooming relationships are affected by their dominance ranks. Seyfarths [1977] grooming for support model and Barrett et al.s [1999] biological market model both predict that in primate grou

  9. Inferential reasoning and modality dependent discrimination learning in olive baboons (Papio hamadryas anubis).

    Science.gov (United States)

    Schmitt, Vanessa; Fischer, Julia

    2009-08-01

    Apes use inferential reasoning by exclusion to locate food both in the visual and auditory domain. To test whether olive baboons (Papio hamadryas anubis) show similar abilities as the apes object choice experiments with differing information about food located in 1 of 2 cups were conducted in the visual and auditory modality. Although all baboons (N = 7) were able to locate the reward when they had previously seen it, they failed to make use of auditory cues or arbitrary acoustic signals. When only partial information was given (i.e., only 1 cup was opened) 4 of the baboons were apparently able to infer the location of the reward by reasoning, whereas the other 3 may have adopted an alternative strategy ("avoid the empty cup"). In addition, 3 of the baboons were able to use arbitrary visual markers to locate the food reward. The results suggest that inferential reasoning is not restricted to apes but is shared with Old World monkeys. Furthermore, they also highlight some important differences in the processing of auditory versus visual information in operant conditioning settings.

  10. Baboons as a model to study genetics and epigenetics of human disease.

    Science.gov (United States)

    Cox, Laura A; Comuzzie, Anthony G; Havill, Lorena M; Karere, Genesio M; Spradling, Kimberly D; Mahaney, Michael C; Nathanielsz, Peter W; Nicolella, Daniel P; Shade, Robert E; Voruganti, Saroja; VandeBerg, John L

    2013-01-01

    A major challenge for understanding susceptibility to common human diseases is determining genetic and environmental factors that influence mechanisms underlying variation in disease-related traits. The most common diseases afflicting the US population are complex diseases that develop as a result of defects in multiple genetically controlled systems in response to environmental challenges. Unraveling the etiology of these diseases is exceedingly difficult because of the many genetic and environmental factors involved. Studies of complex disease genetics in humans are challenging because it is not possible to control pedigree structure and often not practical to control environmental conditions over an extended period of time. Furthermore, access to tissues relevant to many diseases from healthy individuals is quite limited. The baboon is a well-established research model for the study of a wide array of common complex diseases, including dyslipidemia, hypertension, obesity, and osteoporosis. It is possible to acquire tissues from healthy, genetically characterized baboons that have been exposed to defined environmental stimuli. In this review, we describe the genetic and physiologic similarity of baboons with humans, the ability and usefulness of controlling environment and breeding, and current genetic and genomic resources. We discuss studies on genetics of heart disease, obesity, diabetes, metabolic syndrome, hypertension, osteoporosis, osteoarthritis, and intrauterine growth restriction using the baboon as a model for human disease. We also summarize new studies and resources under development, providing examples of potential translational studies for targeted interventions and therapies for human disease.

  11. Mapping cocaine binding sites in human and baboon brain in vivo.

    Science.gov (United States)

    Fowler, J S; Volkow, N D; Wolf, A P; Dewey, S L; Schlyer, D J; Macgregor, R R; Hitzemann, R; Logan, J; Bendriem, B; Gatley, S J

    1989-01-01

    The first direct measurements of cocaine binding in the brain of normal human volunteers and baboons have been made by using positron emission tomography (PET) and tracer doses of [N-11C-methyl]-(-)-cocaine ([11C]cocaine). Cocaine's binding and release from brain are rapid with the highest regional uptake of carbon-11 occurring in the corpus striatum at 4-10 minutes after intravenous injection of labeled cocaine. This was followed by a clearance to half the peak value at about 25 minutes with the overall time course paralleling the previously documented time course of the euphoria experienced after intravenous cocaine administration. Blockade of the dopamine reuptake sites with nomifensine reduced the striatal but not the cerebellar uptake of [11C]cocaine in baboons indicating that cocaine binding is associated with the dopamine reuptake site in the corpus striatum. A comparison of labeled metabolites of cocaine in human and baboon plasma showed that while cocaine is rapidly metabolized in both species, the profile of labeled metabolites is different, with baboon plasma containing significant amounts of labeled carbon dioxide, and human plasma containing no significant labeled carbon dioxide. These studies demonstrate the feasibility of using [11C]cocaine and PET to map binding sites for cocaine in human brain, to monitor its kinetics, and to characterize its binding mechanism by using appropriate pharmacological challenges.

  12. Sarcoglycan complex in masseter and sternocleidomastoid muscles of baboons: an immunohistochemical study

    Directory of Open Access Journals (Sweden)

    G. Cutroneo

    2015-06-01

    Full Text Available The sarcoglycan complex consists of a group of single-pass transmembrane glycoproteins that are essential to maintain the integrity of muscle membranes. Any mutation in each sarcoglycan gene causes a series of recessive autosomal dystrophin-positive muscular dystrophies. Negative fibres for sarcoglycans have never been found in healthy humans and animals. In this study, we have investigated whether the social ranking has an influence on the expression of sarcoglycans in the skeletal muscles of healthy baboons. Biopsies of masseter and sternocleidomastoid muscles were processed for confocal immunohistochemical detection of sarcoglycans. Our findings showed that baboons from different social rankings exhibited different sarcoglycan expression profiles. While in dominant baboons almost all muscles were stained for sarcoglycans, only 55% of muscle fibres showed a significant staining. This different expression pattern is likely to be due to the living conditions of these primates. Sarcoglycans which play a key role in muscle activity by controlling contractile forces may influence the phenotype of muscle fibres, thus determining an adaptation to functional conditions. We hypothesize that this intraspecies variation reflects an epigenetic modification of the muscular protein network that allows baboons to adapt progressively to a different social status.

  13. Sarcoglycan complex in masseter and sternocleidomastoid muscles of baboons: an immunohistochemical study.

    Science.gov (United States)

    Cutroneo, G; Centofanti, A; Speciale, F; Rizzo, G; Favaloro, A; Santoro, G; Bruschetta, D; Milardi, D; Micali, A; Di Mauro, D; Vermiglio, G; Anastasi, G; Trimarchi, F

    2015-06-05

    The sarcoglycan complex consists of a group of single-pass transmembrane glycoproteins that are essential to maintain the integrity of muscle membranes. Any mutation in each sarcoglycan gene causes a series of recessive autosomal dystrophin-positive muscular dystrophies. Negative fibres for sarcoglycans have never been found in healthy humans and animals. In this study, we have investigated whether the social ranking has an influence on the expression of sarcoglycans in the skeletal muscles of healthy baboons. Biopsies of masseter and sternocleidomastoid muscles were processed for confocal immunohistochemical detection of sarcoglycans. Our findings showed that baboons from different social rankings exhibited different sarcoglycan expression profiles. While in dominant baboons almost all muscles were stained for sarcoglycans, only 55% of muscle fibres showed a significant staining. This different expression pattern is likely to be due to the living conditions of these primates. Sarcoglycans which play a key role in muscle activity by controlling contractile forces may influence the phenotype of muscle fibres, thus determining an adaptation to functional conditions. We hypothesize that this intraspecies variation reflects an epigenetic modification of the muscular protein network that allows baboons to adapt progressively to a different social status.

  14. Methoxychlor and its metabolites inhibit growth and induce atresia of baboon antral follicles.

    Science.gov (United States)

    Gupta, Rupesh K; Aberdeen, Graham; Babus, Janice K; Albrecht, Eugene D; Flaws, Jodi A

    2007-08-01

    Methoxychlor (MXC), an organochlorine pesticide, inhibits growth and induces atresia of antral follicles in rodents. MXC metabolites, mono-OH MXC (mono-OH) and bis-OH MXC (HPTE), are thought to be more toxic than the parent compound. Although studies have examined effects of MXC in rodents, few studies have evaluated the effects of MXC in primates. Therefore, the present study tested the hypothesis that MXC, mono-OH, and HPTE inhibit growth and induce atresia of baboon antral follicles. To test this hypothesis, antral follicles were isolated from adult baboon ovaries and cultured with vehicle (dimethylsulfoxide; DMSO), MXC (1-100 micro g/ml), mono-OH (0.1-10 micro g/ml), or HPTE (0.1-10 micro g/ml) for 96 hr. Growth was monitored at 24 hr intervals. After culture, follicles were processed for histological evaluation of atresia. MXC, mono-OH, and HPTE significantly inhibited follicular growth and increased atresia compared to DMSO. Moreover, the adverse effects of MXC and its metabolites on growth and atresia in baboon antral follicles were observed at lower (100-fold) doses than those causing similar effects in rodents. These data suggest that MXC and its metabolites inhibit growth and induce atresia of baboon antral follicles, and that primate follicles are more sensitive to MXC than rodent follicles.

  15. Carbon-11 labelled ketamine-synthesis, distribution in mice and PET studies in baboons

    Energy Technology Data Exchange (ETDEWEB)

    Shiue, C.-Y.; Vallabhahosula, Shankar; Wolf, Alfred P.; Dewey, Stephen L.; Fowler, Joanna S.; Schlyer, David J.; Arnett, Carroll D.; Zhou Yiguo

    1997-02-01

    No-carrier-added (NCA)[{sup 11}C]({+-})-ketamine (2a) and its enantiomers (+)-2b and (-)-2c were synthesized by methylation of the corresponding norketamine (1a-c) with [{sup 11}C]H{sub 3}I in an overall radiochemical yield of 20% (EOB) with specific activities of 0.35-0.45 Ci/{mu}mole at EOB in a synthesis time of 40 min from EOB. Compound 2a was metabolized rapidly in mouse brain and labeled metabolites appeared in baboon plasma. PET studies of compounds 2a-c in a baboon showed that influx of compounds 2a-c into the brain was high for the first few min but radioactivity then declined rapidly. Although the retention of radioactivity in the baboon striatum was not significantly different for 2a-c 20 min post-injection, graphical analysis of time-activity data for each enantiomer and for the racemate in baboon striatum suggested that (+)-ketamine may interact with receptors slightly more effectively than its (-)-enantiomer or racemate. However, due to its rapid metabolism in the brain and a similar uptake in the striatum and cerebellum, [{sup 11}C]ketamine may not be an ideal tracer for studying NMDA receptor with PET.

  16. Cerebral aspects of neonatal extracorporeal membrane oxygenation: a review.

    NARCIS (Netherlands)

    Mol, A.C. de; Liem, K.D.; Heijst, A.F.J. van

    2013-01-01

    Background: Neonatal extracorporeal membrane oxygenation (ECMO) is a lifesaving therapeutic approach in newborns suffering from severe, but potentially reversible, respiratory insufficiency, mostly complicated by neonatal persistent pulmonary hypertension. However, cerebral damage, intracerebral hem

  17. Motor performance after neonatal extracorporeal membrane oxygenation: a longitudinal evaluation

    NARCIS (Netherlands)

    Cammen-Zijp, M.H. van der; Janssen, A.J.W.M.; Raets, M.M.; Rosmalen, J. van; Govaert, P.; Steiner, K.; Gischler, S.J.; Tibboel, D.; Heijst, A.F.J. van; Ijsselstijn, H.

    2014-01-01

    OBJECTIVE: To assess longitudinally children's motor performance 5 to 12 years after neonatal extracorporeal membrane oxygenation (ECMO) and to evaluate associations between clinical characteristics and motor performance. METHODS: Two hundred fifty-four neonatal ECMO survivors in the Netherlands wer

  18. Pleistocene aridification cycles shaped the contemporary genetic architecture of Southern African baboons.

    Directory of Open Access Journals (Sweden)

    Riashna Sithaldeen

    Full Text Available Plio-Pleistocene environmental change influenced the evolutionary history of many animal lineages in Africa, highlighting key roles for both climate and tectonics in the evolution of Africa's faunal diversity. Here, we explore diversification in the southern African chacma baboon Papio ursinus sensu lato and reveal a dominant role for increasingly arid landscapes during past glacial cycles in shaping contemporary genetic structure. Recent work on baboons (Papio spp. supports complex lineage structuring with a dominant pulse of diversification occurring 1-2Ma, and yet the link to palaeoenvironmental change remains largely untested. Phylogeographic reconstruction based on mitochondrial DNA sequence data supports a scenario where chacma baboon populations were likely restricted to refugia during periods of regional cooling and drying through the Late Pleistocene. The two lineages of chacma baboon, ursinus and griseipes, are strongly geographically structured, and demographic reconstruction together with spatial analysis of genetic variation point to possible climate-driven isolating events where baboons may have retreated to more optimum conditions during cooler, drier periods. Our analysis highlights a period of continuous population growth beginning in the Middle to Late Pleistocene in both the ursinus and the PG2 griseipes lineages. All three clades identified in the study then enter a state of declining population size (Nef through to the Holocene; this is particularly marked in the last 20,000 years, most likely coincident with the Last Glacial Maximum. The pattern recovered here conforms to expectations based on the dynamic regional climate trends in southern Africa through the Pleistocene and provides further support for complex patterns of diversification in the region's biodiversity.

  19. Mitochondrial Genome Analyses Suggest Multiple Trichuris Species in Humans, Baboons, and Pigs from Different Geographical Regions.

    Directory of Open Access Journals (Sweden)

    Mohamed B F Hawash

    Full Text Available The whipworms Trichuris trichiura and Trichuris suis are two parasitic nematodes of humans and pigs, respectively. Although whipworms in human and non-human primates historically have been referred to as T. trichiura, recent reports suggest that several Trichuris spp. are found in primates.We sequenced and annotated complete mitochondrial genomes of Trichuris recovered from a human in Uganda, an olive baboon in the US, a hamadryas baboon in Denmark, and two pigs from Denmark and Uganda. Comparative analyses using other published mitochondrial genomes of Trichuris recovered from a human and a porcine host in China and from a françois' leaf-monkey (China were performed, including phylogenetic analyses and pairwise genetic and amino acid distances. Genetic and protein distances between human Trichuris in Uganda and China were high (~19% and 15%, respectively suggesting that they represented different species. Trichuris from the olive baboon in US was genetically related to human Trichuris in China, while the other from the hamadryas baboon in Denmark was nearly identical to human Trichuris from Uganda. Baboon-derived Trichuris was genetically distinct from Trichuris from françois' leaf monkey, suggesting multiple whipworm species circulating among non-human primates. The genetic and protein distances between pig Trichuris from Denmark and other regions were roughly 9% and 6%, respectively, while Chinese and Ugandan whipworms were more closely related.Our results indicate that Trichuris species infecting humans and pigs are phylogenetically distinct across geographical regions, which might have important implications for the implementation of suitable and effective control strategies in different regions. Moreover, we provide support for the hypothesis that Trichuris infecting primates represents a complex of cryptic species with some species being able to infect both humans and non-human primates.

  20. Plasmapheresis and other extracorporeal filtration techniques in critical patients.

    Science.gov (United States)

    Daga Ruiz, D; Fonseca San Miguel, F; González de Molina, F J; Úbeda-Iglesias, A; Navas Pérez, A; Jannone Forés, R

    2017-04-01

    Plasmapheresis is an extracorporeal technique that eliminates macromolecules involved in pathological processes from plasma. A review is made of the technical aspects, main indications in critical care and potential complications of plasmapheresis, as well as of other extracorporeal filtration techniques such as endotoxin-removal columns and other devices designed to eliminate cytokines or modulate the inflammatory immune response in critical patients. Copyright © 2016 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  1. Prolonged Extracorporeal Membrane Oxygenation Support for Acute Respiratory Distress Syndrome

    Directory of Open Access Journals (Sweden)

    Wen-Je Ko

    2006-01-01

    Full Text Available When all conventional treatments for respiratory failure in patients with acute respiratory distress syndrome (ARDS have failed, extracorporeal membrane oxygenation (ECMO can provide a chance of survival in these desperately ill patients. A 49-year-old male patient developed septic shock and progressive ARDS after liver abscess drainage. Venovenous ECMO was given due to refractory respiratory failure on postoperative day 6. Initially, two heparin-binding hollow-fiber microporous membrane oxygenators in parallel were used in the ECMO circuit. Twenty-two oxygenators were changed in the first 22 days of ECMO support because of plasma leak in the oxygenators. Each oxygenator had an average life of 48 hours. Thereafter, a single silicone membrane oxygenator was used in the ECMO circuit, which did not require change during the remaining 596 hours of ECMO. The patient's tidal volume was only 90 mL in the nadir and less than 300 mL for 26 days during the ECMO course. The patient required ECMO support for 48 days and survived despite complications, including septic shock, ARDS, acute renal failure, drug-induced leukopenia, and multiple internal bleeding. This patient received an unusually long duration of ECMO support. However, he survived, recovered well, and was in New York Heart Association functional class I-II, with a forced expiratory volume in 1 second of 81% of the predicted level 18 months later. In conclusion, ECMO can provide a chance of survival for patients with refractory ARDS. The reversibility of lung function is possible in ARDS patients regardless of the severity of lung dysfunction at the time of treatment.

  2. Extracorporeal membrane oxygenation-hemostatic complications.

    Science.gov (United States)

    Murphy, Deirdre A; Hockings, Lisen E; Andrews, Robert K; Aubron, Cecile; Gardiner, Elizabeth E; Pellegrino, Vincent A; Davis, Amanda K

    2015-04-01

    The use of extracorporeal membrane oxygenation (ECMO) support for cardiac and respiratory failure has increased in recent years. Improvements in ECMO oxygenator and pump technologies have aided this increase in utilization. Additionally, reports of successful outcomes in supporting patients with respiratory failure during the 2009 H1N1 pandemic and reports of ECMO during cardiopulmonary resuscitation have led to increased uptake of ECMO. Patients requiring ECMO are a heterogenous group of critically ill patients with cardiac and respiratory failure. Bleeding and thrombotic complications remain a leading cause of morbidity and mortality in patients on ECMO. In this review, we describe the mechanisms and management of hemostatic, thrombotic and hemolytic complications during ECMO support.

  3. Extracorporeal shock wave therapy for tendinopathies.

    Science.gov (United States)

    Seil, Romain; Wilmes, Philippe; Nührenbörger, Christian

    2006-07-01

    Shock waves, as applied in urology and gastroenterology, were introduced in the middle of the last decade in Germany to treat different pathologies of the musculoskeletal system, including epicondylitis of the elbow, plantar fasciitis, and calcifying and noncalcifying tendinitis of the rotator cuff. With the noninvasive nature of these waves and their seemingly low complication rate, extracorporeal shock wave therapy (ESWT) seemed a promising alternative to the established conservative and surgical options in the treatment of patients with chronically painful conditions. However, the apparent advantages of the method led to a rapid diffusion and even inflationary use of ESWT; prospective, randomized studies on the mechanisms and effects of shock waves on musculoskeletal tissues were urgently needed to define more accurate indications and optimize therapeutic outcome. This review covers recent international research in the field and presents actual indications and results in therapy of musculoskeletal conditions with ESWT.

  4. Extracorporeal shock wave therapy (ESWT) in urology

    DEFF Research Database (Denmark)

    Fojecki, Grzegorz Lukasz; Thiessen, Stefan; Osther, Palle Jörn Sloth

    2017-01-01

    PURPOSE: The objective was to evaluate high-level evidence studies of extracorporeal shock wave therapy (ESWT) for urological disorders. METHODS: We included randomized controlled trials reporting outcomes of ESWT in urology. Literature search on trials published in English using EMBASE, Medline...... and PubMed was carried out. The systematic review was performed according to PRISMA guidelines. RESULTS: We identified 10 trials on 3 urological indications. Two of 3 trials on Peyronie's disease (PD) involving 238 patients reported improvement in pain; however, no clinical significant changes in penile......i) responders in 2 of 4 trials and 3 of 4 trials, respectively. Three studies on chronic pelvic pain (CPP) engaging 200 men reported positive changes in National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI). There was considerable heterogeneity between trials both with regard...

  5. The EXTRIP (EXtracorporeal TReatments In Poisoning) workgroup

    DEFF Research Database (Denmark)

    Lavergne, Valéry; Nolin, Thomas D; Hoffman, Robert S

    2012-01-01

    Extracorporeal treatments (ECTRs), such as hemodialysis and hemoperfusion, are used in poisoning despite a lack of controlled human trials demonstrating efficacy. To provide uniform recommendations, the EXTRIP group was formed as an international collaboration among recognized experts from nephro...... of recommendation. This approach will permit the production of the first important practice guidelines on this topic....... nephrology, clinical toxicology, critical care, or pharmacology and supported by over 30 professional societies. For every poison, the clinical benefit of ECTR is weighed against associated complications, alternative therapies, and costs. Rigorous methodology, using the AGREE instrument, was developed...... to retrieve all original publications regardless of language. Data were extracted on a standardized instrument. Quality of the evidence was assessed by GRADE as: High = A, Moderate = B, Low = C, Very Low = D. For every poison, dialyzability was assessed and clinical effect of ECTR summarized. All pertinent...

  6. Road and Street Centerlines, Baboon Peak, Published in 2007, 1:24000 (1in=2000ft) scale, Iron County.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — , published at 1:24000 (1in=2000ft) scale, was produced all or in part from Other information as of 2007. It is described as 'Baboon Peak'. The extent of these data...

  7. Experimental infections of baboons (Papio spp. and vervet monkeys (Cercopithecus aethiops with Trichinella zimbabwensis and successful treatment with ivermectin

    Directory of Open Access Journals (Sweden)

    S. Mukaratirwa

    2008-08-01

    Full Text Available Experimental Trichinella zimbabwensis infections were established in three baboons (Papios p.and four vervet monkeys (Cercopithecuase thiops and the clinical-pathological manifestations assessed. The infected animals showed clinical signs ranging from fever, diarrhoea, periorbitaol edema and muscular pain in varying degrees. One baboon became blind due to the infection. Levels of creatinine phosphokinase and lactated ehydrogenase increased to reach a peak on Day 42 post-infection(pifor both baboons and monkeys. Blood parameters such as packed cell volume, levels of red blood cells and white blood cells did not change significantly from the normal ranges except for the levels of eosinophils which peaked above the normal ranges at Day 28 and 56 pi in baboons and at Day 56 pi in monkeys.

  8. Extracorporeal life support for refractory ventricular tachycardia

    Science.gov (United States)

    Joseph, Nicholas; Hofmann, James P.; Saranteas, Theodosios; Papadimos, Thomas J.

    2017-01-01

    Extracorporeal life support (ECLS) is a very effective bridging therapy in patients with refractory ventricular tachycardia (VT) associated with cardiogenic shock. A moribund patient in extremis, is not amenable to optimization by standard ACC/AHA guidelines. New approaches and novel salvage techniques are necessary to improve outcomes in patients with refractory clinical settings such as malignant ventricular arrhythmias, cardiac arrest, cardiogenic shock and/or pulmonary failure until further management options are explored. Data base searches were done using key words such as ECLS, VT, cardiac arrest, VT ablation, venoarterial extra-corporeal membrane oxygenation (VA-ECMO). The use of ECLS has been described in a few case reports to facilitate VT ablation for incessant VT refractory to medical therapy. For patients with, out-of- hospital ventricular fibrillation (VF) and VT, Minnesota Resuscitation Consortium has implemented emergent advanced perfusion and reperfusion strategy, followed by coronary angiography and primary coronary intervention to improve outcome. The major indications for ECLS are cardiogenic shock related to acute myocardial infarction, myocarditis, post embolic acute cor pulmonale, drug intoxication and post cardiac arrest syndrome with the threat of multi-organ failure. ECLS permits the use of negative inotropic antiarrhythmic drug therapy, facilitates the weaning of catecholamine administration, thereby ending the vicious cycle of catecholamine driven electric storm. ECLS provides hemodynamic support during ablation procedure, while mapping and induction of VT is undertaken. ECLS provides early access to cardiac catheterization laboratory in patients with cardiac arrest due to shockable rhythm. The current evidence from literature, supports the use of ECLS to ensure adequate vital organ perfusion in patients with refractory VT. ECLS is a safe, feasible and effective therapeutic option when conventional therapies are insufficient to support

  9. Brucella papionis sp. nov., isolated from baboons (Papio spp.).

    Science.gov (United States)

    Whatmore, Adrian M; Davison, Nicholas; Cloeckaert, Axel; Al Dahouk, Sascha; Zygmunt, Michel S; Brew, Simon D; Perrett, Lorraine L; Koylass, Mark S; Vergnaud, Gilles; Quance, Christine; Scholz, Holger C; Dick, Edward J; Hubbard, Gene; Schlabritz-Loutsevitch, Natalia E

    2014-12-01

    Two Gram-negative, non-motile, non-spore-forming coccoid bacteria (strains F8/08-60(T) and F8/08-61) isolated from clinical specimens obtained from baboons (Papio spp.) that had delivered stillborn offspring were subjected to a polyphasic taxonomic study. On the basis of 16S rRNA gene sequence similarities, both strains, which possessed identical sequences, were assigned to the genus Brucella. This placement was confirmed by extended multilocus sequence analysis (MLSA), where both strains possessed identical sequences, and whole-genome sequencing of a representative isolate. All of the above analyses suggested that the two strains represent a novel lineage within the genus Brucella. The strains also possessed a unique profile when subjected to the phenotyping approach classically used to separate species of the genus Brucella, reacting only with Brucella A monospecific antiserum, being sensitive to the dyes thionin and fuchsin, being lysed by bacteriophage Wb, Bk2 and Fi phage at routine test dilution (RTD) but only partially sensitive to bacteriophage Tb, and with no requirement for CO2 and no production of H2S but strong urease activity. Biochemical profiling revealed a pattern of enzyme activity and metabolic capabilities distinct from existing species of the genus Brucella. Molecular analysis of the omp2 locus genes showed that both strains had a novel combination of two highly similar omp2b gene copies. The two strains shared a unique fingerprint profile of the multiple-copy Brucella-specific element IS711. Like MLSA, a multilocus variable number of tandem repeat analysis (MLVA) showed that the isolates clustered together very closely, but represent a distinct group within the genus Brucella. Isolates F8/08-60(T) and F8/08-61 could be distinguished clearly from all known species of the genus Brucella and their biovars by both phenotypic and molecular properties. Therefore, by applying the species concept for the genus Brucella suggested by the ICSP

  10. The effects of extracorporeal shock wave therapy on frozen shoulder patients’ pain and functions

    OpenAIRE

    2015-01-01

    [Purpose] The present study was conducted to examine the effects of extracorporeal shock wave therapy on frozen shoulder patients’ pain and functions. [Subjects] In the present study, 30 frozen shoulder patients were divided into two groups: an extracorporeal shock wave therapy group of 15 patients and a conservative physical therapy group of 15 patients. [Methods] Two times per week for six weeks, the extracorporeal shock wave therapy group underwent extracorporeal shock wave therapy, and th...

  11. Exact focusing of extracorporeal shock wave therapy for calcifying tendinopathy.

    Science.gov (United States)

    Haake, Michael; Deike, Barbara; Thon, Alexander; Schmitt, Jan

    2002-04-01

    A controlled prospective randomized study was designed to analyze the effect of extracorporeal shock wave therapy on calcifying tendinopathy of the shoulder focused on the calcified area or the origin of the supraspinatus tendon. Fifty patients were included in the study and were treated with a Storz Minilith Sl-1 shock wave generator. The first group of patients received 4000 impulses (positive energy flux density, 0.78 mJ/mm2) in two treatment sessions after receiving local anesthesia at the origin of the supraspinatus tendon. Patients in the second group received extracorporeal shock wave therapy at the calcified area. Follow-ups were done 12 weeks and 1 year after treatment by an independent observer. An increase of function and a reduction of pain occurred in both groups. Statistical analyses showed a significant superiority of extracorporeal shock wave application at the calcified area in the primary end point (Constant and Murley score). Therefore, exact fluoroscopic focusing of extracorporeal shock wave therapy at the calcific deposit for treatment of calcifying tendinopathy of the supraspinatus muscle is recommended. Based on these results, extracorporeal shock wave application should be focused fluoroscopically with appropriate shock wave generators.

  12. Guidelines for reporting case studies on extracorporeal treatments in poisonings

    DEFF Research Database (Denmark)

    Lavergne, Valéry; Ouellet, Georges; Bouchard, Josée

    2014-01-01

    A literature review performed by the EXtracorporeal TReatments In Poisoning (EXTRIP) workgroup highlighted deficiencies in the existing literature, especially the reporting of case studies. Although general reporting guidelines exist for case studies, there are none in the specific field of extra......A literature review performed by the EXtracorporeal TReatments In Poisoning (EXTRIP) workgroup highlighted deficiencies in the existing literature, especially the reporting of case studies. Although general reporting guidelines exist for case studies, there are none in the specific field...... of extracorporeal treatments in toxicology. Our goal was to construct and propose a checklist that systematically outlines the minimum essential items to be reported in a case study of poisoned patients undergoing extracorporeal treatments. Through a modified two-round Delphi technique, panelists (mostly chosen...... reports containing data on extracorporeal treatments in poisoning published in Medline in 2011 were reviewed during the external validation rounds. Twenty-one panelists (20 from the EXTRIP workgroup and an invited expert on pharmacology reporting guidelines) participated in the modified Delphi technique...

  13. Baboon syndrome: an unusual complication arising from antibiotic treatment of tonsillitis and review of the literature.

    Science.gov (United States)

    Blackmur, James Peter; Lammy, Simon; Baring, David E C

    2013-11-28

    A 40-year-old man presented with sore throat and fevers associated with bilaterally enlarged and inflamed tonsils. A clinical diagnosis of tonsillitis was made and the patient received intravenous benzylpenicillin. Over subsequent days, the patient developed a macular rash over both groins, buttocks and axillae, with necrotic patches in the groins. An assumptive diagnosis of necrotising fasciitis was made. The patient underwent urgent groin biopsy and was started on broad spectrum antibiotics. No organisms were seen on Gram stain. Following a multidisciplinary discussion, the patient was diagnosed with baboon syndrome (symmetrical drug-related intertriginous and flexural exanthema). He was treated with oral steroid along with topical agents. Baboon syndrome can develop following penicillin administration. Given the widespread use of penicillin antibiotics to treat tonsillitis and many other conditions, it is important that medical staff recognise the side effects of these medications.

  14. Protective Effect of Chronic Schistosomiasis in Baboons Coinfected with Schistosoma mansoni and Plasmodium knowlesi

    DEFF Research Database (Denmark)

    Nyakundi, Ruth K; Nyamongo, Onkoba; Maamun, Jeneby

    2016-01-01

    Malaria and schistosomiasis coinfections are common, and chronic schistosomiasis has been implicated in affecting the severity of acute malaria. However, whether it enhances or attenuates malaria has been controversial due the lack of appropriately controlled human studies and relevant animal...... models. To examine this interaction, we conducted a randomized controlled study using the baboon (Papio anubis) to analyze the effect of chronic schistosomiasis on severe malaria. Two groups of baboons (n = 8 each) and a schistosomiasis control group (n = 3) were infected with 500 Schistosoma mansoni...... cercariae. At 14 and 15 weeks postinfection, one group was given praziquantel to treat schistosomiasis infection. Four weeks later, the two groups plus a new malaria control group (n = 8) were intravenously inoculated with 10(5) Plasmodium knowlesi parasites and monitored daily for development of severe...

  15. Role of Grooming in Reducing Tick Load in Wild Baboons (Papio cynocephalus).

    Science.gov (United States)

    Akinyi, Mercy Y; Tung, Jenny; Jeneby, Maamun; Patel, Nilesh B; Altmann, Jeanne; Alberts, Susan C

    2013-03-01

    Nonhuman primate species spend a conspicuous amount of time grooming during social interactions, a behavior that probably serves both social and health-related functions. While the social implications of grooming have been relatively well studied, less attention has been paid to the health benefits, especially the removal of ectoparasites, which may act as vectors in disease transmission. In this study, we examined the relationship between grooming behavior, tick load (number of ticks), and haemoprotozoan infection status in a population of wild free-ranging baboons (Papio cynocephalus). We found that the amount of grooming received was influenced by an individual's age, sex and dominance rank. The amount of grooming received, in turn, affected the tick load of an individual. Baboons with higher tick loads had lower packed red cell volume (PCV or haematocrit), one general measure of health status. We detected a tick-borne haemoprotozoan, Babesia microti, but its low prevalence in the population precluded identifying sources of variance in infection.

  16. Activation of porcine cytomegalovirus, but not porcine lymphotropic herpesvirus, in pig-to-baboon xenotransplantation.

    Science.gov (United States)

    Mueller, Nicolas J; Livingston, Christine; Knosalla, Christoph; Barth, Rolf N; Yamamoto, Shin; Gollackner, Bernd; Dor, Frank J M F; Buhler, Leo; Sachs, David H; Yamada, Kazuhiko; Cooper, David K C; Fishman, Jay A

    2004-05-01

    Tissue-invasive disease due to porcine cytomegalovirus (PCMV) has been demonstrated after pig-to-baboon solid-organ xenotransplantation. Porcine lymphotropic herpesvirus (PLHV)-1 is associated with B cell proliferation and posttransplant lymphoproliferative disorder after allogeneic bone marrow transplantation in swine but has not been observed in pig-to-primate xenotransplantation. Activation of PCMV and PLHV-1 was investigated in 22 pig-to-baboon xenotransplants by use of quantitative polymerase chain reaction. PCMV was found in all xenografts; increased viral replication occurred in 68% of xenografts during immunosuppression. PLHV-1 was found in 12 xenografts (55%); no increases in viral replication occurred during immunosuppression. Control immunosuppressed swine coinfected with PCMV and PLHV-1 had activation of PCMV but not PLHV-1. PCMV, but not PLHV-1, is activated in solid-organ xenotransplantation.

  17. Mitochondrial genome analyses suggest multiple Trichuris species in humans, baboons, and pigs from different geographical regions

    DEFF Research Database (Denmark)

    Hawash, Mohamed B. F.; Andersen, Lee O.; Gasser, Robin B.;

    2015-01-01

    BACKGROUND: The whipworms Trichuris trichiura and Trichuris suis are two parasitic nematodes of humans and pigs, respectively. Although whipworms in human and non-human primates historically have been referred to as T. trichiura, recent reports suggest that several Trichuris spp. are found...... in primates. METHODS AND FINDINGS: We sequenced and annotated complete mitochondrial genomes of Trichuris recovered from a human in Uganda, an olive baboon in the US, a hamadryas baboon in Denmark, and two pigs from Denmark and Uganda. Comparative analyses using other published mitochondrial genomes...... of Trichuris recovered from a human and a porcine host in China and from a françois' leaf-monkey (China) were performed, including phylogenetic analyses and pairwise genetic and amino acid distances. Genetic and protein distances between human Trichuris in Uganda and China were high (~19% and 15%, respectively...

  18. Distribution of immunoglobulin allotypes among local populations of Kenya olive baboons.

    Science.gov (United States)

    Oliver, T J; Coppenhaver, D H; Steinberg, A G

    1986-05-01

    In this paper we report on the distributions of immunoglobulin allotypes among 564 olive baboons collected at six localities in Kenya. The sample localities and sizes are 1) Lake Magadi, N = 107; 2) Nanyuki, N = 77; 3) Lake Baringo, N = 55; 4) Mosiro, N = 132; 5) Isiolo, N = 36; 6) Gilgil, N = 157. Gm allotypes 1, 10, 13, 15, and 17 are polymorphic among these samples. Gm(11) and Km(3) were present in all samples, and Gm(2,3,5,6,14,16,21,24,26) and Km(1) were absent from all samples. The proportions of individuals positive for polymorphic allotypes varied substantially between different local samples, as did the arrays and estimated frequencies of haplotypes. Allotype frequencies in local samples do not appear to be simply related to either geographic location or habitat characteristics of the localities. Our data suggest that much of the geographic variability in Kenya olive baboon populations occurs between populations separated by small geographic distances.

  19. Zoledronic acid-associated symmetrical drug-related intertriginous and flexural exanthema (SDRIFE): report of baboon syndrome in a woman with recurrent metastatic breast cancer after receiving zoledronic acid

    OpenAIRE

    Cohen, Philip R.

    2015-01-01

    Background:  Baboon syndrome is a distinctive skin reaction in which the patient typically develops erythematous buttocks that appear similar to those of a baboon.  The non-contact allergenic variant of baboon syndrome is also referred to as symmetrical drug-related intertriginous and flexural exanthema (SDRIFE).  Zoledronic acid is a bisphosphonate that is used in patients with metastatic cancer to prevent bone complications. Purpose:  Zoledronic acid-associated baboon syndrome is ...

  20. The Ontogeny of the Endocrine Pancreas in the Fetal/Newborn Baboon

    Science.gov (United States)

    Quinn, Amy R.; Blanco, Cynthia L.; Perego, Carla; Finzi, Giovanna; La Rosa, Stefano; Capella, Carlo; Guardado-Mendoza, Rodolfo; Casiraghi, Francesca; Gastaldelli, Amalia; Johnson, Marney; Dick, Edward J.; Folli, Franco

    2013-01-01

    Background Erratic regulation of glucose metabolism including hyperglycemia is a common condition of premature infants and is associated with increased morbidity and mortality. Objective To examine histological and ultra-structural differences in the endocrine pancreas in fetal (throughout gestation) and neonatal baboons. Methods Twelve fetal baboons were delivered at 125 days (d) gestational age (GA), 140dGA, or 175dGA. Eight animals were delivered at term (185dGA); half were fed for 5d. Seventy-three non-diabetic adult baboons were used for comparison. Pancreatic tissue was studied utilizing light microscopy, confocal imaging and electron microscopy. Results The fetal and neonatal endocrine pancreas islet architecture became more organized as GA advanced. The percent areas of α-β-δ-cell type were similar within each fetal and newborn GA (NS), but were higher than the adults (P<0.05) regardless of GA. The ratio of β-cells within the islet (whole and core) increased with gestation (P<0.01). Neonatal baboons who survived for 5 days (feeding), had a 2.5-fold increase in pancreas weight compared to their counterparts euthanized at birth (P=0.01). Endocrine cells were found amongst exocrine ductal and acinar cells in 125,140 and 175dGA fetuses. Subpopulation of cells that co-expressed trypsin and glucagon/insulin show the presence of cells with mixed endo-exocrine lineage in fetuses. Conclusions The fetal endocrine pancreas has no prevalence of a of α-β-δ-cell type with larger endocrine cell percent areas than adults. Cells with mixed endocrine/exocrine phenotype occur during fetal development. Developmental differences may play a role in glucose homeostasis during the neonatal period and may have long term implications. PMID:22723715

  1. Serum Vitamin D Concentrations in Baboons (Papio spp.) during Pregnancy and Obesity

    OpenAIRE

    Schlabritz-Loutsevitch, Natalia E.; Comuzzie, Anthony G.; Mahaney, Michael M; Hubbard, Gene B.; DICK, EDWARD J.; Kocak, Mehmet; Gupta, Sonali; Carrillo, Maira; Schenone, Mauro; Postlethwaite, Arnold; Slominski, Andrzej

    2016-01-01

    Obesity is associated with vitamin D deficiency, which can lead to serious problems during pregnancy. However, the mechanisms of the deficiency and guidelines for vitamin D supplementation during pregnancy are not established yet, and variations in environmental exposures combined with the difficulties of performing research in pregnant women are obstacles in the evaluation of vitamin D metabolism. Baboons (Papio spp.) are an excellent, well-established model for reproductive research and rep...

  2. Antenatal Corticosteroids Alter Insulin Signaling Pathways in Fetal Baboon Skeletal Muscle

    Science.gov (United States)

    BLANCO, Cynthia L.; MOREIRA, Alvaro G.; McGILL, Lisa L.; ANZUETO, Diana G.; NATHANIELSZ, Peter; MUSI, Nicolas

    2015-01-01

    Objective We hypothesize that prenatal exposure to glucocorticoids (GCs) will negatively alter the insulin signal transduction pathway and has differing effects on the fetus according to gestational age at exposure. Methods Twenty-three fetal baboons were delivered from twenty-three healthy, non-diabetic mothers. Twelve preterm (0.67 gestational age) and eleven near term (0.95 gestational age) baboons were euthanized immediately after delivery. Half of the pregnant baboons at each gestation received two doses of intramuscular betamethasone 24-hours apart (170 μg.kg−1) before delivery, while the other half received no intervention. Vastus lateralis muscle was obtained from postnatal animals to measure protein content and gene expression of insulin receptor (IR)-β, IR-β Tyr 1361 phosphorylation (pIR-β), IR substate-1 (IRS-1), IRS-1 tyrosine phosphorylation (pIRS-1), p85 subunit of PI3-kinase (p85), Akt (Protein Kinase B), phospho-Akt Ser473 (pAkt), Akt-1, Akt-2, and glucose transporters (GLUT1 and GLUT4). Results Skeletal muscle from preterm baboons exposed to glucocorticoids had markedly reduced protein content of Akt and Akt-1 (respectively, 73% and 72% from 0.67 gestational age Control, P<0.001); IR-β and pIR-β were decreased (respectively, 94% and 85%, P<0.01) in the muscle of premature GC exposed fetuses, but not in term fetuses. GLUT1 and GLUT4 tended to increase with GC exposure in preterm animals (P=0.09), while GLUT4 increased 6.0 fold in term animals after GC exposure (P<0.05). Conclusion Exposure to a single course of antenatal GCs during fetal life alters the insulin-signaling pathway in fetal muscle in a manner dependent on the stage of gestation. PMID:24756099

  3. Treponema pallidum infection in the wild baboons of East Africa: distribution and genetic characterization of the strains responsible.

    Science.gov (United States)

    Harper, Kristin N; Fyumagwa, Robert D; Hoare, Richard; Wambura, Philemon N; Coppenhaver, Dorian H; Sapolsky, Robert M; Alberts, Susan C; Tung, Jenny; Rogers, Jeffrey; Kilewo, Morris; Batamuzi, Emmanuel K; Leendertz, Fabian H; Armelagos, George J; Knauf, Sascha

    2012-01-01

    It has been known for decades that wild baboons are naturally infected with Treponema pallidum, the bacterium that causes the diseases syphilis (subsp. pallidum), yaws (subsp. pertenue), and bejel (subsp. endemicum) in humans. Recently, a form of T. pallidum infection associated with severe genital lesions has been described in wild baboons at Lake Manyara National Park in Tanzania. In this study, we investigated ten additional sites in Tanzania and Kenya using a combination of macroscopic observation and serology, in order to determine whether the infection was present in each area. In addition, we obtained genetic sequence data from six polymorphic regions using T. pallidum strains collected from baboons at two different Tanzanian sites. We report that lesions consistent with T. pallidum infection were present at four of the five Tanzanian sites examined, and serology was used to confirm treponemal infection at three of these. By contrast, no signs of treponemal infection were observed at the six Kenyan sites, and serology indicated T. pallidum was present at only one of them. A survey of sexually mature baboons at Lake Manyara National Park in 2006 carried out as part of this study indicated that roughly ten percent displayed T. pallidum-associated lesions severe enough to cause major structural damage to the genitalia. Finally, we found that T. pallidum strains from Lake Manyara National Park and Serengeti National Park were genetically distinct, and a phylogeny suggested that baboon strains may have diverged prior to the clade containing human strains. We conclude that T. pallidum infection associated with genital lesions appears to be common in the wild baboons of the regions studied in Tanzania. Further study is needed to elucidate the infection's transmission mode, its associated morbidity and mortality, and the relationship between baboon and human strains.

  4. Homeothermy and primate bipedalism: is water shortage or solar radiation the main threat to baboon (Papio hamadryas) homeothermy?

    Science.gov (United States)

    Mitchell, Duncan; Fuller, Andrea; Maloney, Shane K

    2009-05-01

    Other than the hominin lineage, baboons are the diurnally active primates that have colonized the arid plains of Africa most successfully. While the hominin lineage adopted bipedalism before colonizing the open, dry plains, baboons retained a quadrupedal mode of locomotion. Because bipedalism has been considered to reduce the thermoregulatory stress of inhabiting open dry plains, we investigated how baboons cope with thermal loads and water restriction. Using implanted data loggers, we measured abdominal temperature every 5 min in six unrestrained baboons while they were exposed to simulated desert conditions (15 degrees C at night rising to 35 degrees C during the day, with and without extra radiant heating), or an ambient temperature of 22 degrees C. At 22 degrees C, core temperature averaged 37.9 degrees C and cycled nychthemerally by 1.7 degrees C. Mean, minimum, and maximum daily core temperatures in euhydrated baboons in the simulated desert environments did not differ from the temperatures displayed in the 22 degrees C environment, even when radiant heating was applied. At 22 degrees C, restricting water intake did not affect core temperature. During the desert simulations, maximum core temperature increased significantly on each day of water deprivation, with the highest temperatures (>40 degrees C) on the third day in the simulation that included radiant heat. When drinking water heated to 38 degrees C was returned, core temperature decreased rapidly to a level lower than normal for that time of day. We conclude that baboons with access to water can maintain homeothermy in the face of high air temperatures and radiant heat loads, but that a lack of access to drinking water poses a major threat to baboon homeothermy. We speculate that any competitive thermoregulatory advantage of bipedalism in early hominins was related to coping with water shortage in hot environments, and that their freed hands might have enabled them to transport enough water to avoid

  5. Treponema pallidum infection in the wild baboons of East Africa: distribution and genetic characterization of the strains responsible.

    Directory of Open Access Journals (Sweden)

    Kristin N Harper

    Full Text Available It has been known for decades that wild baboons are naturally infected with Treponema pallidum, the bacterium that causes the diseases syphilis (subsp. pallidum, yaws (subsp. pertenue, and bejel (subsp. endemicum in humans. Recently, a form of T. pallidum infection associated with severe genital lesions has been described in wild baboons at Lake Manyara National Park in Tanzania. In this study, we investigated ten additional sites in Tanzania and Kenya using a combination of macroscopic observation and serology, in order to determine whether the infection was present in each area. In addition, we obtained genetic sequence data from six polymorphic regions using T. pallidum strains collected from baboons at two different Tanzanian sites. We report that lesions consistent with T. pallidum infection were present at four of the five Tanzanian sites examined, and serology was used to confirm treponemal infection at three of these. By contrast, no signs of treponemal infection were observed at the six Kenyan sites, and serology indicated T. pallidum was present at only one of them. A survey of sexually mature baboons at Lake Manyara National Park in 2006 carried out as part of this study indicated that roughly ten percent displayed T. pallidum-associated lesions severe enough to cause major structural damage to the genitalia. Finally, we found that T. pallidum strains from Lake Manyara National Park and Serengeti National Park were genetically distinct, and a phylogeny suggested that baboon strains may have diverged prior to the clade containing human strains. We conclude that T. pallidum infection associated with genital lesions appears to be common in the wild baboons of the regions studied in Tanzania. Further study is needed to elucidate the infection's transmission mode, its associated morbidity and mortality, and the relationship between baboon and human strains.

  6. Extracorporeal membrane oxygenation support in potential organ donors for brain death determination.

    Science.gov (United States)

    Hsieh, C-E; Lin, H-C; Tsui, Y-C; Lin, P-Y; Lin, K-H; Chang, Y-Y; Chen, Y-L

    2011-09-01

    Extracorporeal membrane oxygenation (ECMO) must be applied in early stages to perfuse organs before donation in order to expand the donor pool. The aim of this study was to examine the benefits of ECMO for potential organ donors with multiple complications. This retrospective review describes patients with ECMO support who were on the verge of brain death and therefore potential subjects for organ donation. Six organ donors with severe neurological damage under ECMO support completed the procedures, namely, two women and four men of ages 19 to 58 years (mean, 32 years). Three donors completed the brain-death determination procedure, one failed the procedure, and two experienced cardiac asystole prior to the procedure and were unable to be declared dead even after resuscitation. Nine kidneys and three livers were successfully retrieved from 5/6 donors, leading to 11 successful transplantations: eight kidneys, two livers, and one simultaneous kidney-liver transplantations. The organs functioned well and the recipients made full recoveries. ECMO allows for the maintenance of abdominal organ tissue perfusion without warm ischemia before organ procurement, providing sufficient time for safe organ donation procedures and reducing the risk of unpredictable cardiac arrest that could result in the donor death and graft loss. Copyright © 2011 Elsevier Inc. All rights reserved.

  7. Mental maps in chacma baboons (Papio ursinus): using inter-group encounters as a natural experiment.

    Science.gov (United States)

    Noser, Rahel; Byrne, Richard W

    2007-07-01

    Encounters between groups of wild chacma baboons (Papio ursinus) can be viewed as a natural experiment to investigate the nature of these primates' mental representations of large-scale space. During a 16-month field study in a high population density habitat we recorded the foraging routes and the most important resources of a group of 25 individuals. Also, we estimated the locations of additional baboon groups relative to the study group. Routes were less linear, travel speed was higher, and inter-resource distances were larger when other groups were present within 500 m of the focal group; thus, the study group avoided others by taking detours. We predicted that evasive manoeuvres would be characteristic of different possible orientation mechanisms, and compared them with our observations. We analysed 34 evasive manoeuvres in detail. In an area that lacked prominent landmarks, detours were small; larger detours occurred when resources were directly visible, or in the vicinity of a hill offering conspicuous landmarks. In areas without prominent landmarks, detours were along familiar routes and waiting bouts of up to 60 min occurred; on one occasion the study group aborted their entire day's journey. We discuss these findings in the light of time and energy costs and suggest that the baboons lack the ability to compute Euclidean relations among locations, but use network maps to find their way to out-of-sight locations.

  8. Relationship between canine dimorphism and mandibular morphology in the hamadryas baboon and the Japanese monkey.

    Science.gov (United States)

    Fukase, Hitoshi

    2011-04-01

    To examine morphological interrelationships between canine size and mandibular corpus shape, inter-sex comparisons were made in the hamadryas baboon and the Japanese monkey, known to display extreme and moderate canine dimorphism, respectively. Results of adult comparisons showed that all mandibular dimensions were significantly larger in the males than in the females in both species. In the hamadryas baboon, the males also exhibited a higher ratio of anterior to posterior corpus height than the females. This sex difference in corpus shape was not significant in the Japanese monkey, indicating lack of involvement of canine dimorphism. Analysis of mandibular growth patterns in the hamadryas baboon demonstrated that significant sexual size difference did not occur before incisor eruption, and that the anteriorly high corpus of the adult male mandible was associated with a rapidly increasing symphyseal height after incisor eruption. It was also shown that the female canine started to erupt shortly after incisor eruption, while the forming male canine continued to stay near the mandibular base and developed further in size until eruption. The relative positions of the incisors kept shifting upwards even after eruption in the males, while they hardly changed in the females. It is therefore suggested that the prolonged development and size increase of the male canine is accompanied by further enlargement of the symphysis, resulting in the higher anterior corpus of the adult males compared to the adult females. The results thus indicate the importance of understanding the spatial relationships of the developing teeth in interpreting mandibular morphology.

  9. A baboon syndrome induced by intravenous human immunoglobulins: report of a case and immunological analysis.

    Science.gov (United States)

    Barbaud, A; Tréchot, P; Granel, F; Lonchamp, P; Faure, G; Schmutz, J L; Béné, M C

    1999-01-01

    Following the second series of intravenous human immunoglobulins (IVIg; 0.4 g/kg) prescribed to treat a sensorimotor polyneuritis, a 28-year-old woman developed pompholyx that recurred after each of the following monthly treatments with IVIg. During the administration of the 10th series, the patient developed a typical baboon syndrome. Immunohistochemical studies of a skin biopsy revealed an unexpected epidermal expression of P-selectin, usually expressed by endothelial cells. Patch, prick and intradermal tests performed with IVIg on the back, arms and buttocks gave negative results on immediate and delayed readings. IVIg were re-administered, with the informed consent of the patient, and induced a generalized maculopapular rash. This is the first reported case of baboon syndrome induced by IVIg. Although extensive skin testing was performed, all test sites remained negative. We wonder whether IVIg could reproduce immunological mechanisms involved in the 3 types of systemic contact dermatitis (pompholyx, baboon syndrome and maculopapular rash), including the epidermal expression of P-selectin.

  10. Serum Vitamin D Concentrations in Baboons (Papio spp.) during Pregnancy and Obesity.

    Science.gov (United States)

    Schlabritz-Loutsevitch, Natalia E; Comuzzie, Anthony G; Mahaney, Michael M; Hubbard, Gene B; Dick, Edward J; Kocak, Mehmet; Gupta, Sonali; Carrillo, Maira; Schenone, Mauro; Postlethwaite, Arnold; Slominski, Andrzej

    2016-04-01

    Obesity is associated with vitamin D deficiency, which can lead to serious problems during pregnancy. However, the mechanisms of the deficiency and guidelines for vitamin D supplementation during pregnancy are not established yet, and variations in environmental exposures combined with the difficulties of performing research in pregnant women are obstacles in the evaluation of vitamin D metabolism. Baboons (Papio spp.) are an excellent, well-established model for reproductive research and represent a unique opportunity to study vitamin D metabolism in a controlled environment. This study used secondary data and specimen analysis as well as a novel experimental design to evaluate pregnant and nonpregnant baboons that were or were not exposed to sunlight while they were obese and after weight reduction. Daily D3 intake was 71% higher in nonpregnant obese baboons than in their nonobese counterparts, but serum vitamin D concentrations did not differ between these populations. In addition, serum 25-hydroxyvitamin D concentrations correlated negatively with the obesity index. This report is the first to show the effect of obesity and pregnancy on vitamin D concentrations in a NHP population. These data underline the importance of adequate vitamin D supplementation in obese animals.

  11. When good neighbors don't need fences: Temporal landscape partitioning among baboon social groups.

    Science.gov (United States)

    Markham, A Catherine; Guttal, Vishwesha; Alberts, Susan C; Altmann, Jeanne

    2013-06-01

    Intraspecific competition is a key factor shaping space-use strategies and movement decisions in many species, yet how and when neighbors utilize shared areas while exhibiting active avoidance of one another is largely unknown. Here we investigated temporal landscape partitioning in a population of wild baboons (Papio cynocephalus). We used global positioning system (GPS) collars to synchronously record the hourly locations of 5 baboon social groups for ~900 days, and we used behavioral, demographic, and life history data to measure factors affecting use of overlap areas. Annual home ranges of neighboring groups overlapped substantially, as predicted (baboons are considered non-territorial), but home ranges overlapped less when space use was assessed over shorter time scales. Moreover, neighboring groups were in close spatial proximity to one another on fewer days than predicted by a null model, suggesting an avoidance-based spacing pattern. At all time scales examined (monthly, biweekly, and weekly), time spent in overlap areas was greater during time periods when groups fed on evenly dispersed, low-quality foods. The percent of fertile females in social groups was negatively correlated with time spent in overlap areas only during weekly time intervals. This suggests that broad temporal changes in ecological resources are a major predictor of how intensively overlap areas are used, and groups modify these ecologically driven spacing patterns at short time scales based on female reproductive status. Together these findings offer insight into the economics of territoriality by highlighting the dynamics of spacing patterns at differing time scales.

  12. Control of plasma renin activity in heat-stressed baboons on varied salt intake.

    Science.gov (United States)

    Proppe, D W

    1987-04-01

    The characteristics and control of the increase in plasma renin activity (PRA) during environmental heating (EH) were determined in 12 unanesthetized, chronically catheterized baboons. Each EH experiment consisted of a 1.5- to 4-h exposure to an ambient temperature of 39-44 degrees C until core temperature (Tc) reached 39.5-40.0 degrees C. These EH experiments were done on the baboon in an unblocked state and during beta-adrenergic receptor blockade produced by propranolol when on normal-to-high salt intake (NHSI) and on low-salt intake (LSI). PRA rose linearly with Tc during EH, but the increase in PRA was considerably larger when the baboon was on LSI. The PRA-Tc linear regression coefficients were 2.32 and 5.98 ng angiotensin I X ml-1 X h-1 X degrees C-1 in NHSI and LSI states, respectively. This rise in PRA during EH was completely eliminated during beta-blockade in both NHSI and LSI states. It is concluded that heat stress activates the sympathetic nervous system to stimulate beta-receptor-mediated renin secretion by the kidney, this activation is controlled primarily by internal thermoreceptors, and variations in salt intake alters only the magnitude of the increase in PRA during heat stress, not the mechanisms that produce it.

  13. Vasopressin contributes to maintenance of arterial blood pressure in dehydrated baboons.

    Science.gov (United States)

    Ryan, K L; Thornton, R M; Proppe, D W

    1989-02-01

    This study primarily sought to determine whether the role of vasopressin (VP) in maintenance of arterial blood pressure is enhanced in awake, chronically instrumented baboons after 68-72 h of dehydration. This question was approached by pharmacologically blocking vasopressin V1-receptors in euhydrated and dehydrated baboons with or without a normally functioning renin-angiotensin system (RAS). VP blockade during dehydration produced a rapidly occurring (within 5 min), statistically significant (P less than 0.05) decrease in mean arterial pressure (MAP) of 5 +/- 1 mmHg in the RAS-intact condition and an identical decline in MAP (5 +/- 1 mmHg) during blockade of the RAS by captopril, an angiotensin I-converting enzyme inhibitor. At 15 min after induction of VP blockade, heart rate was elevated by 9 +/- 2 beats/min in the RAS-intact condition and by 20 +/- 5 beats/min in the RAS-blocked condition. In addition, VP blockade in the dehydrated state produced small and equal increases in hindlimb vascular conductance in RAS-intact and RAS-blocked conditions. None of these cardiovascular changes were produced by VP blockade in the euhydrated state. RAS blockade produced modest declines in MAP in both hydration states, but the fall was larger by 7 +/- 4 mmHg in the dehydrated state. Thus both VP and the RAS contribute to the maintenance of arterial blood pressure during dehydration in the conscious baboon.

  14. Synergy between angiotensin and aldosterone in evoking sodium appetite in baboons.

    Science.gov (United States)

    Shade, R E; Blair-West, J R; Carey, K D; Madden, L J; Weisinger, R S; Denton, D A

    2002-11-01

    The synergy between ANG II and aldosterone (Aldo) in the induction of salt appetite, extensively studied in rats, has been tested in baboons. ANG II was infused intracerebroventricularly at 0.5 or 1.0 microg/h; Aldo was infused subcutaneously at 20 microg/h. Separate infusions over 7 days had no significant effect on the daily intake of 300 mM NaCl. Concurrent infusions, however, increased daily NaCl intake approximately 10-fold and daily water intake approximately 2.5-fold. In addition, the combined infusions caused 1) a reduction in daily food intake, 2) changes in blood composition indicative of increased vasopressin release, and 3) changes of urinary excretion rates of cortisol and Aldo indicative of increased ACTH release. Arterial blood pressure, measured in two baboons, rose during concurrent ANG II and Aldo treatment. These results indicate a potent synergy between central ANG II and peripheral Aldo in stimulating salt appetite in baboons. At the same time, other ANG II-specific brain mechanisms concerned with water intake, food intake, vasopressin release, ACTH release, and blood pressure regulation appear to have been activated by the same type of synergy. These central enhancement processes have never been previously demonstrated in primates.

  15. Extracorporeal membrane oxygenation for adult respiratory failure.

    Science.gov (United States)

    Turner, David A; Cheifetz, Ira M

    2013-06-01

    Extracorporeal membrane oxygenation (ECMO) is a form of cardiopulmonary bypass that is a mainstay of therapy in neonatal and pediatric patients with life threatening respiratory and/or cardiac failure. Historically, the use of ECMO in adults has been limited, but recent reports and technological advances have increased utilization and interest in this technology in adult patients with severe respiratory failure. As ECMO is considered in this critically ill population, patient selection, indications, contraindications, comorbidities, and pre-ECMO support are all important considerations. Once the decision is made to cannulate a patient for ECMO, meticulous multi-organ-system management is required, with a priority being placed on lung rest and minimization of ventilator-induced lung injury. Close monitoring is also necessary for complications, some of which are related to ECMO and others secondary to the patient's underlying degree of illness. Despite the risks, reports demonstrate survival > 70% in some circumstances for patients requiring ECMO for refractory respiratory failure. As the utilization of ECMO in adult patients with respiratory failure continues to expand, ongoing discussion and investigation are needed to determine whether ECMO should remain a "rescue" therapy or if earlier ECMO may be beneficial as a lung-protective strategy.

  16. Compact intra- and extracorporeal oxygenator developments.

    Science.gov (United States)

    Cattaneo, Giorgio; Strauss, Andreas; Reul, Helmut

    2004-07-01

    For patients with acute lung failure, mechanical ventilation entails the risk of lung tissue damage due to high oxygen pressure and concentration. Membrane oxygenation for one to two weeks can rest the lungs due to decreased ventilation parameters, representing a potential bridge to recovery, but implies the substantial risks of blood damage, plasma leakage and infection, which often have fatal results for patients. At the Helmholtz Institute in Aachen, two types of membrane oxygenators, which aim to overcome previous limits, are under development. Both present compact designs, reduced surface and priming volumes and easier handling. HEXMO is a miniaturized extracorporeal membrane oxygenator. The integration of a small rotary blood pump into the centre of the oxygenator reduces the amount of tubing and connectors in the system. Blood is convectively warmed by the pump motor housing, thus, the use of a heat-exchanger can be avoided. This compact design reduces surface and priming volume and allows better handling, especially in critical situations. A second development is the intravascular oxygenator HIMOX, which is inserted directly into the vena cava. Priming volume and blood contact surface are reduced, as well as infection risk and control needs for the patient. A new cross-flow fibre configuration is used for improving gas transfer within the limited space inside the vena cava. A microaxial blood pump is integrated into the device for compensating the pressure drop across the fibres and allowing venous return and physiological pressure in the organs proximal to the oxygenator.

  17. Extracorporeal shockwave therapy in musculoskeletal disorders

    Directory of Open Access Journals (Sweden)

    Wang Ching-Jen

    2012-03-01

    Full Text Available Abstract The sources of shockwave generation include electrohydraulic, electromagnetic and piezoelectric principles. Electrohydraulic shockwaves are high-energy acoustic waves generated under water explosion with high voltage electrode. Shockwave in urology (lithotripsy is primarily used to disintegrate urolithiasis, whereas shockwave in orthopedics (orthotripsy is not used to disintegrate tissues, rather to induce tissue repair and regeneration. The application of extracorporeal shockwave therapy (ESWT in musculoskeletal disorders has been around for more than a decade and is primarily used in the treatment of sports related over-use tendinopathies such as proximal plantar fasciitis of the heel, lateral epicondylitis of the elbow, calcific or non-calcific tendonitis of the shoulder and patellar tendinopathy etc. The success rate ranged from 65% to 91%, and the complications were low and negligible. ESWT is also utilized in the treatment of non-union of long bone fracture, avascular necrosis of femoral head, chronic diabetic and non-diabetic ulcers and ischemic heart disease. The vast majority of the published papers showed positive and beneficial effects. FDA (USA first approved ESWT for the treatment of proximal plantar fasciitis in 2000 and lateral epicondylitis in 2002. ESWT is a novel non-invasive therapeutic modality without surgery or surgical risks, and the clinical application of ESWT steadily increases over the years. This article reviews the current status of ESWT in musculoskeletal disorders.

  18. Patient and personnel exposure during extracorporeal lithotripsy

    Energy Technology Data Exchange (ETDEWEB)

    Glaze, S.; LeBlanc, A.D.; Bushong, S.C.; Griffith, D.P.

    1987-12-01

    Extracorporeal shock wave lithotripsy (ESWL) has provided a nonsurgical approach to treatment of renal stones. The Dornier lithotripter uses dual image intensified x-ray systems to center the stone before treatment. Three imaging modes are offered: a fluoroscopic mode and two video spot filming modes. The average entrance exposure to the stone side of the typical patient at our facility is 2.6 X 10(-3) C kg-1 (10 R) (range: 0.5-7.7 X 10(-3) C kg-1 (2-30 R)) which is comparable and often much less than that reported for percutaneous lithotripsy. Recommendations are made for minimizing patient exposure. Scattered radiation levels in the lithotripter room are presented. We have determined that Pb protective apparel is not required during this procedure provided x-ray operation is temporarily halted should personnel be required to lean directly over the tub to attend to the patient. If the walls of the ESWL room are greater than 1.83 m (6 feet) from the tub, shielding in addition to conventional construction is not required.

  19. Patient and personnel exposure during extracorporeal lithotripsy.

    Science.gov (United States)

    Glaze, S; LeBlanc, A D; Bushong, S C; Griffith, D P

    1987-12-01

    Extracorporeal shock wave lithotripsy (ESWL) has provided a nonsurgical approach to treatment of renal stones. The Dornier lithotripter uses dual image intensified x-ray systems to center the stone before treatment. Three imaging modes are offered: a fluoroscopic mode and two video spot filming modes. The average entrance exposure to the stone side of the typical patient at our facility is 2.6 X 10(-3) C kg-1 (10 R) [range: 0.5-7.7 X 10(-3) C kg-1 (2-30 R)] which is comparable and often much less than that reported for percutaneous lithotripsy. Recommendations are made for minimizing patient exposure. Scattered radiation levels in the lithotripter room are presented. We have determined that Pb protective apparel is not required during this procedure provided x-ray operation is temporarily halted should personnel be required to lean directly over the tub to attend to the patient. If the walls of the ESWL room are greater than 1.83 m (6 feet) from the tub, shielding in addition to conventional construction is not required.

  20. [Extracorporeal shock-wave therapy. Experimental basis, clinical application].

    Science.gov (United States)

    Rompe, J D; Küllmer, K; Vogel, J; Eckardt, A; Wahlmann, U; Eysel, P; Hopf, C; Kirkpatrick, C J; Bürger, R; Nafe, B

    1997-03-01

    The purpose of our studies was to investigate experimentally the dose-dependent effects of extracorporeal shock waves on tendon and bone and to unveil therapeutic possibilities in tendinopathies and pseudarthroses. In animal experiments, both positive and negative influences were exerted by shock waves, depending on the initial situation and on the power of the applied shock waves. In prospective clinical trials positive effects were found in the treatment of persistent tennis elbow, plantar fasciitis, calcifying tendinitis, and pseudarthrosis. Our data show that extracorporeal shock waves may provide analgesic, resorptive and osteo-inductive reactions with nearly no side effects. However, the high cost of apparatus and staff prevents a routine application. Extracorporeal shock waves thus remain a last alternative before the indication is made for an operative procedure.

  1. Extracorporeal Membrane Oxygenation Applications in Cardiac Critical Care.

    Science.gov (United States)

    Raleigh, Lindsay; Ha, Rich; Hill, Charles

    2015-12-01

    The use of extracorporeal membrane oxygenation therapy (ECMO) in cardiac critical care has steadily increased over the past decade. Significant improvements in the technology associated with ECMO have propagated this recent resurgence and contributed to improved patient outcomes in the fields of cardiac and transplant (heart and lung) surgery. Specifically, ECMO is being increasingly utilized as a bridge to heart and lung transplantation, as well as to ventricular assist device placement. ECMO is also employed during the administration of cardiopulmonary resuscitation, known as extracorporeal life support. In this review, we examine the recent literature regarding the applications of ECMO and also describe emerging topics involving current ECMO management strategies.

  2. Extracorporeal shock-wave lithotripsy of gallstones. Results and perspectives

    Energy Technology Data Exchange (ETDEWEB)

    Staritz, M.; Rambow, A.; Meyer zum Bueschenfelde, K.H.; Floth, A.; Hohenfellner, R.; Mildenberger, P.; Thelen, M.; Goebel, M.

    1987-12-01

    Recently extracorporeal shock-wave lithotripsy became a noteworthy alternative in the treatment of choledocolithiasis and cholecystolithiasis, in particular since the introduction of the second-generation shock-wave technique which allows to dispense with the positioning of the patient in the water bath required sofar and to place the patient on an examination table in freely movable way so as to position the gall stone to be disintegrated in the focus of the shock waves. Despite the beneficial treatment results, extracorporeal shock-wave lithotripsy still needs further improvement as a method especially in terms of the option of 'pulverizing' the stones. (orig./TRV)

  3. Superior Mesenteric Artery Dissection after Extracorporeal Shockwave Lithotripsy

    Directory of Open Access Journals (Sweden)

    Christos Bakoyiannis

    2012-01-01

    Full Text Available The use of shockwave lithotripsy is currently the mainstay of treatment in renal calculosis. Several complications including vessel injuries have been implied to extracorporeal shockwave lithotripsy. We report an isolated dissection of the superior mesenteric artery in a 60-year-old male presenting with abdominal pain which occurred three days after extracorporeal shockwave lithotripsy. The patient was treated conservatively and the abdominal pain subsided 24 hours later. The patient's history, the course of his disease, and the timing may suggest a correlation between the dissection and the ESWL.

  4. In Vivo Quantification of Clot Formation in Extracorporeal Circuits

    CERN Document Server

    David, Omid

    2012-01-01

    Clot formation is a common complication in extracorporeal circuits. In this paper we describe a novel method for clot formation analysis using image processing. We assembled a closed extracorporeal circuit and circulated blood at varying speeds. Blood filters were placed in downstream of the flow, and clotting agents were added to the circuit. Digital images of the filter were subsequently taken, and image analysis was applied to calculate the density of the clot. Our results show a significant correlation between the cumulative size of the clots, the density measure of the clot based on image analysis, and flow duration in the system.

  5. Evaluation of cell death after treatment with extracorporeal photopheresis.

    Science.gov (United States)

    Daniele, Nicola; Del Proposto, Gianpaolo; Cerrone, Paola; Sinopoli, Silvia; Sansone, Lucia; Gadaleta, Deborah Ilaria; Lanti, Alessandro; Ferraro, Angelo Salvatore; Spurio, Stefano; Scerpa, Maria Cristina; Zinno, Francesco; Adorno, Gaspare; Isacchi, Giancarlo

    2012-02-01

    The aim of our study is to assess the mortality of leukocytes during extracorporeal photopheresis. Sixty-three photopheresis performed on 13 patients affected by chronic GvHD were evaluated. Samples were analyzed using a FACSCalibur flow cytometer. Apoptosis and necrosis of limphomononuclear cells dramatically increased after the apheretic procedure. We found a further increase of apoptotic and necrotic limphomononuclear cells after treatment with 8-MOP and UVA (p≤0.05). Our data suggested that the immunomodulatory effects of extracorporeal photopheresis, triggered by circulating apoptotic or necrotic cells, could play an important role in the treatment of GvHD with this procedure.

  6. Efficacy of fenbendazole formulated in a commercial primate diet for treating specific pathogen-free baboons (Papio cynocephalus anubis) infected with Trichuris trichiura.

    Science.gov (United States)

    Reichard, Mason V; Wolf, Roman F; Clingenpeel, Lindsay C; Doan, Sandra K; Jones, Amy N; Gray, Kristene M

    2008-11-01

    Trichuris trichiura is a common intestinal nematode parasite of captive baboons. We evaluated the efficacy of fenbendazole formulated in a commercial primate diet (FBZ-PD) for treating specific pathogen-free (SPF) baboons (Papio cynocephalus anubis) naturally infected with Trichuris trichiura. Twenty-nine baboons, housed indoors in 3 separate rooms, were fed FBZ-PD for 5 d, whereas 4 baboons housed in another isolated area served as untreated controls. The efficacy of FBZ-PD was measured as reduction in the number of T. trichiura eggs in host feces after treatment as determined by quantitative fecal flotation examination. All baboons that received FBZ-PD stopped shedding T. trichiura eggs by 7 d after initiation of treatment, and remained negative until at least 119 d after treatment. However, eggs of T. trichiura were present in the feces of 3 (10.3%) experimental baboons at 154 d after treatment. Untreated control baboons shed T. trichiura eggs throughout the entire study. Our results indicate that FBZ-PD was efficacious for treating SPF baboons infected with T. trichiura.

  7. Follow up of infection of chacma baboons with inoculum containing a and non-a genotypes of hepatitis B virus

    Institute of Scientific and Technical Information of China (English)

    Marina Baptista; Anna Kramvis; Saffie Jammeh; Jocelyn Naicker; Jacqueline S.Galpin; Michael C.Kew

    2003-01-01

    AIM: To determine whether one genotype (A or non-A genotypes of HBV) predominated over the other during the course of HBV infection.METHODS: Four baboons were inoculated with HBV. DNA was extracted from serum obtained at monthly intervals postinoculation for 52 weeks and HBV DNA was amplified using primers specific for the core region containing an insert characteristic of genotype A (nt 2 354-2 359, numbering from the EcoRI site). The amplicons were cloned into PCRScriptTM and a minimum of 15 clones per time point were sequenced in both directions.RESULTS: Both genotypes persisted for the entire followup period of 52 weeks. Genotype non-A predominated in two baboons and genotype A in one baboon. Neither genotype predominated in the fourth baboon, as shown at a 5 % level of testing.CONCLUSION: No conclusions concerning the dominance of either genotype or the natural progression or replication rates of HBV could be drawn because the pattern of the genotypes found may have been caused by sampling fluctuations at the time of DNA extraction and cloning as a result of the very low viral loads in the baboon sera.

  8. Gaze following in baboons (Papio anubis): juveniles adjust their gaze and body position to human's head redirections.

    Science.gov (United States)

    Parron, Carole; Meguerditchian, Adrien

    2016-12-01

    Gaze following, the ability to follow the gaze of other individuals, has been widely studied in non-human primate species, mostly in adult individuals. Yet, the literature on gaze following revealed a quite variability across the different findings, some of it might reflect true inter-species differences, while others might be related to methodological differences, or to an underestimation of the factors involved in the expression of gaze following. In the current study, we tested 54 captive olive baboons (Papio anubis), housed in social groups, to assess how juvenile and adult baboons would spontaneously react to a sudden change in the direction of a human experimenter's head. First, our results showed that juveniles, more than adult baboons, co-oriented their gaze with the experimenter's gaze. We also observed a strong habituation effect in adult baboons but not in juveniles, as the adults' response vanished at the second exposure to a change of direction of the experimenter's head. Second, our results showed that juveniles subsequently adopted an original strategy when the experimenter's head indicated some new directions: they reliably adjusted their spatial body position to keep a gaze contact with the experimenter's line of sight. We discussed how the age class and the individual expertise of the baboons could lead to some modulations in terms of attentiveness, motivation, or cognitive abilities, and thus likely influence gaze following.

  9. Establishment and Characterization of Baboon Embryonic Stem Cell Lines An Old World Primate Model for Regeneration and Transplantation Research

    Science.gov (United States)

    Simerly, Calvin R.; Navara, Christopher S.; Castro, Carlos A.; Turpin, Janet C.; Redinger, Carrie J.; Mich-Basso, Jocelyn D.; Jacoby, Ethan S.; Grund, Kevin J.; McFarland, David A.; Oliver, Stacie L.; Ben-Yehudah, Ahmi; Carlisle, Diane L.; Frost, Patricia; Penedo, Cecilia; Hewitson, Laura; Schatten, Gerald

    2010-01-01

    Here we have developed protocols using the baboon as a complementary alternative Old World Primate to rhesus and other macaques which have severe limitations in their availability. Baboons are not limited as research resources, they are evolutionarily closer to humans and the multiple generations of pedigreed colonies which display complex human disease phenotypes all support their further optimization an invaluable primate model. Since neither baboon assisted reproductive technologies nor baboon embryonic stem cells (ESCs) have been reported, here we describe the first derivations and characterization of baboon ESC lines from IVF-generated blastocysts. Two ESCs lines (BabESC-4 and BabESC-15) display ESC morphology, express pluripotency markers (Oct-4, hTert, Nanog, Sox-2, Rex-1, TRA1–60, TRA1–81), and maintain stable euploid female karyotypes with parentage confirmed independently. They have been grown continuously for >430 and 290 days, respectively. Teratomas from both lines have all three germ layers. Availabilities of these BabESCs represent another important resource for stem cell biologists. PMID:19393591

  10. Simulation training for extracorporeal membrane oxygenation

    Directory of Open Access Journals (Sweden)

    Roberta Brum

    2015-01-01

    Full Text Available Background: Extracorporeal membrane oxygenation (ECMO is a complex treatment. Despite this, there are a lack of training programs designed to develop relevant clinical and nonclinical skills required for ECMO specialists. The aim of the current study was to describe the design, implementation and evaluation of a 1-day simulation course for delivering training in ECMO. Methods: A 1-day simulation course was developed with educational and intensive care experts. First, the delegates received a lecture on the principles of simulation training and the importance of human factors. This was, followed by a practical demonstration and discussion of the ECMO circuit, console components, circuit interactions effects and potential complications. There were then five ECMO simulation scenarios with debriefing that covered technical and nontechnical issues. The course culminated in a knowledge-based assessment. Course outcomes were assessed using purpose-designed questionnaires. Results: We held 3 courses with a total of 14 delegates (9 intensive care nurses, 3 adult intensive care consultants and 2 ECMO technicians. Following the course, 8 (57% gained familiarity in troubleshooting an ECMO circuit, 6 (43% increased their familiarity with the ECMO pump and circuit, 8 (57% perceived an improvement in their communication skills and 7 (50% perceived an improvement in their leadership skills. At the end of the course, 13 (93% delegates agreed that they felt more confident in dealing with ECMO. Conclusions: Simulation-training courses may increase knowledge and confidence in dealing with ECMO emergencies. Further studies are indicated to determine whether simulation training improves clinical outcomes and translates to reduced complication rates in patients receiving ECMO.

  11. Neonatal respiratory extracorporeal membrane oxygenation (ECMO) referrals.

    LENUS (Irish Health Repository)

    El-Khuffash, A

    2011-03-01

    Extracorporeal membrane oxygenation (ECMO) is a complex technique for providing life support in neonatal respiratory failure. T UK Collaborative ECMO trial demonstrated cost-effectiveness and substantial improvements in neurological morbidity and mortality. Currently, infants requiring ECMO in Ireland are referred to one of various centres in the UK and Scandinavia. We aimed to review the number of infants referred from Ireland for respiratory ECMO. All infants with a non-cardiac condition referred from Ireland for ECMO were reviewed for diagnosis and outcomes. Eleven infants required ECMO between June 2006 and January 2009 and were referred to the Scandinavian team for ECMO transport although one infant improved and did not require ECMO following the arrival of the team. Four infants died: one infant died prior to arrival of the ECMO team, 3 infants had fatal diagnoses and one infant with congenital diaphragmatic hernia received pre-op ECMO. The median (inter-quartile range) gestational age was 39.7 (38.3-40.7) weeks and birth weight of 3.7 (3.2-4.0) kg. The median age at the decision to transfer for ECMO was 13h (4-123) and the team arrived at 23 h (12-132). All infants had a normal cranial ultrasound and echo prior to ECMO and 2 infants had an abnormal MRI post-ECMO. The time on ECMO was 9 days (3-17) and total length of hospital stay was 32 d (23-36). There were no pre-ECMO clinical or biochemical

  12. [Extracorporeal shock wave therapy in chronic prostatitis].

    Science.gov (United States)

    Kul'chavenya, E V; Shevchenko, S Yu; Brizhatyuk, E V

    2016-04-01

    Chronic prostatitis is a prevalent urologic disease, but treatment outcomes are not always satisfactory. As a rule, chronic prostatitis results in chronic pelvic pain syndrome, significantly reducing the patient's quality of life. Open pilot prospective non-comparative study was conducted to test the effectiveness of extracorporeal shock wave therapy (ESWT) using Aries (Dornier) machine in patients with chronic prostatitis (CP) of IIIb category. A total of 27 patients underwent ESWL as monotherapy, 2 times a week for a course of 6 sessions. Exposure settings: 5-6 energy level (by sensation), the frequency of 5 Hz, 2000 pulses per session; each patient received a total energy up to 12000 mJ. per procedure. Treatment results were evaluated using NIH-CPSI (National Institute of Health Chronic Prostatitis Symptom Index) upon completing the 3 week course of 6 treatments and at 1 month after ESWT. Immediately after the ESWT course positive trend was not significant: pain index decreased from 9.1 to 7.9, urinary symptom score remained almost unchanged (4.2 at baseline, 4.1 after treatment), quality of life index also showed a slight improvement, dropping from 7.2 points to 6.0. Total NIH-CPSI score decreased from 20.5 to 18.0. One month post-treatment pain significantly decreased to 3.2 points, the urinary symptom score fell to 2.7 points, the average quality of life score was 3.9 points. ESWT, performed on Aries (Dornier) machine, is highly effective as monotherapy in patients with category IIIb chronic prostatitis.

  13. Liver Facts

    Science.gov (United States)

    ... Lung Kidney Pancreas Kidney/Pancreas Liver Intestine Liver Facts How the Liver Works The liver is one ... Camps for kids Contacting my donor family Data Facts about living donation Financing a transplant Matching organs ...

  14. Progress in bioreactors of bioartiifcial livers

    Institute of Scientific and Technical Information of China (English)

    Cheng-Bo Yu; Xiao-Ping Pan; Lan-Juan Li

    2009-01-01

    BACKGROUND: Bioartiifcial liver support systems are becoming an effective therapy for hepatic failure. Bioreactors, as key devices in these systems, can provide a favorable growth and metabolic environment, mass exchange, and immunological isolation as a platform. Currently, stagnancy in bioreactor research is the main factor restricting the development of bioartiifcial liver support systems. DATA SOURCES: A PubMed database search of English-language literature was performed to identify relevant articles using the keywords "bioreactor", "bioartiifcial liver", "hepatocyte", and "liver failure". More than 40 articles related to the bioreactors of bioartiifcial livers were reviewed. RESULTS: Some progress has been made in the improvement of structures, functions, and modiifed macromolecular materials related to bioreactors in recent years. The current data on the improvement of bioreactor conifgurations for bioartiifcial livers or on the potential of the use of certain scaffold materials in bioreactors, combined with the clinical efifcacy and safety evaluation of cultured hepatocytesin vitro, indicate that the AMC (Academic Medical Center) BAL bioreactor and MELS (modular extracorporeal liver support) BAL bioreactor system can partly replace the synthetic and metabolic functions of the liver in phaseⅠ clinical studies. In addition, it has been indicated that the microlfuidic PDMS (polydimethylsiloxane) bioreactor, or SlideBioreactor, and the microfabricated grooved bioreactor are appropriate for hepatocyte culture, which is also promising for bioartiifcial livers. Similarly, modiifed scaffolds can promote the adhesion, growth, and function of hepatocytes, and provide reliable materials for bioreactors.CONCLUSIONS: Bioreactors, as key devices in bioartiifcial livers, play an important role in the therapy for liver failure both now and in the future. Bioreactor conifgurations are indispensable for the development of bioartiifcial livers used for liver

  15. Unfocused extracorporeal shock waves induce anabolic effects in osteoporotic rats

    NARCIS (Netherlands)

    van der Jagt, Olav P.; Waarsing, Jan H.; Kops, Nicole; Schaden, Wolfgang; Jahr, Holger; Verhaar, Jan A. N.; Weinans, Harrie

    2013-01-01

    Unfocused extracorporeal shock waves (UESW) have been shown to have an anabolic effect on bone mass. Therefore we investigated the effects of UESW on bone in osteoporotic rats with and without anti-resorptive treatment. Twenty-week-old rats were ovariectomized (n=27). One group was treated with sali

  16. Stenting and extracorporeal shock wave lithotripsy in chronic pancreatitis

    DEFF Research Database (Denmark)

    Holm, M; Matzen, Peter

    2003-01-01

    BACKGROUND: Early observational studies of endoscopic treatment and extracorporeal shock wave lithotripsy (ESWL) reported considerable or complete relief of pain in 50%-80% of patients with chronic pancreatitis. There is no consensus on the measurement of pain, making comparison of observational...

  17. Automatic Control of Veno-Venous Extracorporeal Lung Assist.

    Science.gov (United States)

    Kopp, Ruedger; Bensberg, Ralf; Stollenwerk, Andre; Arens, Jutta; Grottke, Oliver; Walter, Marian; Rossaint, Rolf

    2016-10-01

    Veno-venous extracorporeal lung assist (ECLA) can provide sufficient gas exchange even in most severe cases of acute respiratory distress syndrome. Commercially available systems are manually controlled, although an automatically controlled ECLA could allow individualized and continuous adaption to clinical requirements. Therefore, we developed a demonstrator with an integrated control algorithm to keep continuously measured peripheral oxygen saturation and partial pressure of carbon dioxide constant by automatically adjusting extracorporeal blood and gas flow. The "SmartECLA" system was tested in six animal experiments with increasing pulmonary hypoventilation and hypoxic inspiratory gas mixture to simulate progressive acute respiratory failure. During a cumulative evaluation time of 32 h for all experiments, automatic ECLA control resulted in a peripheral oxygen saturation ≥90% for 98% of the time with the lowest value of 82% for 15 s. Partial pressure of venous carbon dioxide was between 40 and 49 mm Hg for 97% of the time with no value 49 mm Hg. With decreasing inspiratory oxygen concentration, extracorporeal oxygen uptake increased from 68 ± 25 to 154 ± 34 mL/min (P automatic control of the extracorporeal circuit. Proof of concept could be demonstrated for this novel automatically controlled veno-venous ECLA circuit. Copyright © 2015 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

  18. Management of retained encrusted urethral catheter with extracorporeal shockwave lithotripsy

    Directory of Open Access Journals (Sweden)

    Sameh Anwar Kunzman

    2002-01-01

    Full Text Available We report a case of non-deflating heavily encrusted Foley catheter successfully removed by extracorporeal shockwave lithotripsy (ESWL. To our knowledge this is the first case of using ESWL to remove encrusted foley catheter retained in the bladder.

  19. Normothermal or Hypothermal Extracorporeal Circulation Regimens in Patients with Acquired Heart Disease

    Directory of Open Access Journals (Sweden)

    V. V. Lomivorotov

    2013-01-01

    Full Text Available Background. Hypothermal extracorporeal circulation has been used in cardiosurgery over 50 years. However, recent trials have not shown its predominant effect on the protection of the brain, lung, and myocardium in patients during surgery. We have presumed that when normothermal extracorporeal circulation used in patients with acquired heart disease, its pathophysiological effect on the body is comparable with that of hypothermal extracorporeal circulation. Subjects and methods. One hundred and forty patients who were to undergo acquired heart disease correction were randomized into two equal groups: that using hypothermal or normothermal extracorporeal circulation. Perioperative troponin I and NT-proBNP concentrations, postoperative clinical course, and hospital morbidity and mortality rates were estimated. Results. There were no significant differences in the concentrations of troponin I and NT-proBNP at the study stages. In the normothermal extracorporeal circulation group patients with isolated aortic stenosis, the concentration of troponin I was higher than that in the hypothermal extracorporeal circulation group. Analyzing the postoperative course indicated that the duration of mechanical ventilation was significantly lower in the hypothermal extracorporeal circulation group than in the normothermal extracorporeal circulation group. There were no differences in hospital complications and mortality rates. Conclusion. Hypothermal versus normothermal extracorporeal circulation in the correction of acquired heart diseases has no predominant effect on tro-ponin I and NT-proBNP concentrations, postoperative clinical course, and hospital complications and mortality rates. Key words: extracorporeal circulation, hypothermia, acquired heart disease, troponin I, NT-proBNP.

  20. MARS therapy, the bridging to liver retransplantation – Three cases from the Hungarian liver transplant program

    Science.gov (United States)

    Fazakas, János; Zádori, Gergely; Görög, Dénes; Kóbori, László; Dabasi, Eszter; Mándli, Tamás; Piros, László; Smudla, Anikó; Szabó, Tamás; Toronyi, Éva; Tóth, Szabolcs; Tőzsér, Gellért; Végső, Gyula; Doros, Attila; Nemes, Balázs

    2013-01-01

    Besides orthotopic liver transplantation (OLT) there is no long-term and effective replacement therapy for severe liver failure. Artificial extracorporeal liver supply devices are able to reduce blood toxin levels, but do not replace any synthetic function of the liver. Molecular adsorbent recirculating system (MARS) is one of the methods that can be used to treat fulminant acute liver failure (ALF) or acute on chronic liver failure (AoCLF). The primary non-function (PNF) of the newly transplanted liver manifests in the clinical settings exactly like acute liver failure. MARS treatment can reduce the severity of complications by eliminating blood toxins, so that it can help hepatic encephalopathy (HE), hepatorenal syndrome (HRS), and the high rate mortality of cerebral herniation. This might serve as a bridging therapy before orthotopic liver retransplantation (reOLT). Three patients after a first liver transplantation became candidate for urgent MARS treatment as a bridging solution prior to reOLT in our center. Authors report these three cases, fo-cusing on indications, MARS sessions, clinical courses, and final outcomes. PMID:24265893

  1. EXTRACORPOREAL PHOTOCHEMOTHERAPY IN PSORIASIS AND PSORIATIC ARTHRITIS

    Directory of Open Access Journals (Sweden)

    E. S. Yakubovskaya

    2016-01-01

    Full Text Available Background: Psoriasis is the most prevalent chronic dermatosis of an autoimmune origin that is characterized by increasing incidence of both severe clinical forms and complications, the most threatening of which is psoriatic arthritis. Its treatment includes aromatic retinoids, immunosuppressant therapies (immunosuppressant agents, glucocorticosteroids, PUVA-therapy and other methods. However, these are insufficiently effective in clinical practice and are frequently associated with serious adverse reactions and complications. Aim: To increase the efficacy of treatment for psoriasis associated with psoriatic arthritis by means of incorporation of a new immunobiological method, the extracorporeal photochemotherapy (EPCT into the standard treatment protocol. Materials and methods: We conducted a  prospective cohort study with an active control. Seventy patients with various forms of psoriasis associated with psoriatic arthritis were randomized with stratifi-cation into two groups. The patients of the main group (n = 35 were treated with EPCT, whereas those from the control group (n = 35 received the standard treatment. The EPCT method included isolation of mononuclear cells preliminary sensitized with 8-methoxypsoralen with a cell separator Haemonetics MCS+. After the cell suspension was treated with UV А  (λ = 320–400  nm, it was re-infused to the patient. The treatment course included 4 sessions performed every other day. Results: The analysis of clinical efficacy of EPCT in the combination treatment of psoriasis associated with psoriatic arthritis demonstrated that in the majority of cases a  significant therapeutic effect was achieved. The mean PASI index decreased from 28.5 ± 1.63 to 6.6 ± 1.7 (p < 0.05, the activity of psoriatic arthritis (DAS score, from 3.7 ± 0.35 to 1.7 ± 0.36 (p < 0.05. This significant treatment effect was associated with a  decreased correlation between expression of activation molecules HLADr by

  2. Fotoferese extracorpórea Extracorporeal photopheresis

    Directory of Open Access Journals (Sweden)

    Márcia M. Silva

    2008-04-01

    Full Text Available Fotoferese extracorpórea é uma modalidade de terapia celular que tem demonstrado eficácia e segurança em pacientes portadores de doenças auto-imunes e mediadas por células T, incluindo esclerodermia, linfoma de células T cutâneo/ Síndrome de Sézary e doença enxerto-contra-hospedeiro após transplante de células-tronco hematopoiéticas. Tem sido empregada, ainda, com o intuito de induzir tolerância em transplantes de órgãos sólidos. O tratamento se baseia no efeito biológico de uma substância fotossensibilizante, o 8-metoxipsoraleno, e da radiação ultravioleta A, nas células mononucleares coletadas por aférese e reinfundidas ao paciente. O mecanismo de ação parece ser devido à indução de imunidade anticlonotípica direcionada a clones patogênicos de células T. O tratamento induz a apoptose de células T patogênicas, e a ativação de células apresentadoras de antígenos desempenha papel importante no processo imunomodulador.Extracorporeal photopheresis is a method of cell therapy that has demonstrated efficacy in autoimmune diseases, cutaneous T-cell lymphoma/Sézary syndrome and graft-versus-host disease after hematopoietic stem-cell transplantation. This technique has also been employed as a treatment strategy to induce tolerance after solid organ transplants. Treatment is based on the biological effect of ultraviolet A radiation and a photosensitizing drug, 8-methoxypsoralen, on mononuclear cells collected by apheresis and reinfused into the patient. The suggested mechanism of action is related to the induction of anticlonotypic immunity directed against pathogenic clones of T lymphocytes. Treatment induces apoptosis of pathogenic T-cells, and it appears that activation of antigen-presenting cells has an important role in this process.

  3. Delayed xenograft rejection of pig-to-baboon cardiac transplants after cobra venom factor therapy.

    Science.gov (United States)

    Kobayashi, T; Taniguchi, S; Neethling, F A; Rose, A G; Hancock, W W; Ye, Y; Niekrasz, M; Kosanke, S; Wright, L J; White, D J; Cooper, D K

    1997-11-15

    This study sought to (i) investigate the efficacy of cobra venom factor (CVF) in preventing hyperacute rejection (HAR) after pig-to-baboon heart transplantation, (ii) examine the effect of additional splenectomy (Spx) and pharmacologic immunosuppression (IS), and (iii) study delayed graft rejection when HAR is avoided by complement depletion. Eleven recipient baboons received heterotopic pig heart transplants. Three received either no therapy or IS (cyclosporine + methylprednisolone +/- cyclophosphamide +/- methotrexate) at clinically well-tolerated doses, with graft survival for only 40, 32, and 15 min, respectively. Two received CVF+/-Spx, which extended survival to 5 and 6 days, respectively. Six underwent Spx + CVF therapy + IS; graft survival was 3 hr (technical complication), 6 days (death from sepsis), 10, 12, and 22 days (vascular rejection), and <25 days (euthanized for viral pneumonia with a functioning graft that showed histopathologic features of vascular rejection). Dense deposition of IgM and, to a lesser extent, IgG and IgA were seen on the endothelial cells within 1 hr of transplantation, but only trace levels of complement deposition were present in CVF-treated recipients. Within approximately 5-12 days, cardiac xenografts showed progressive infiltration by mononuclear cells, consisting primarily of activated macrophages producing tumor necrosis factor-alpha and small numbers of natural killer cells; T and B cells were absent. We conclude that (i) CVF prevents HAR, (ii) the addition of Spx + IS delays rejection, but (iii) the early deposition of antibody leads to progressive graft injury, resulting in (iv) delayed vascular rejection. Our findings indicate that the features of delayed xenograft rejection described in small animal models also occur in the pig-to-baboon model, and that rejection may occur in a complement-independent manner from the effects of antibody and/or host macrophages.

  4. Training experience in gestures affects the display of social gaze in baboons' communication with a human.

    Science.gov (United States)

    Bourjade, Marie; Canteloup, Charlotte; Meguerditchian, Adrien; Vauclair, Jacques; Gaunet, Florence

    2015-01-01

    Gaze behaviour, notably the alternation of gaze between distal objects and social partners that accompanies primates' gestural communication is considered a standard indicator of intentionality. However, the developmental precursors of gaze behaviour in primates' communication are not well understood. Here, we capitalized on the training in gestures dispensed to olive baboons (Papio anubis) as a way of manipulating individual communicative experience with humans. We aimed to delineate the effects of such a training experience on gaze behaviour displayed by the monkeys in relation with gestural requests. Using a food-requesting paradigm, we compared subjects trained in requesting gestures (i.e. trained subjects) to naïve subjects (i.e. control subjects) for their occurrences of (1) gaze behaviour, (2) requesting gestures and (3) temporal combination of gaze alternation with gestures. We found that training did not affect the frequencies of looking at the human's face, looking at food or alternating gaze. Hence, social gaze behaviour occurs independently from the amount of communicative experience with humans. However, trained baboons-gesturing more than control subjects-exhibited most gaze alternation combined with gestures, whereas control baboons did not. By reinforcing the display of gaze alternation along with gestures, we suggest that training may have served to enhance the communicative function of hand gestures. Finally, this study brings the first quantitative report of monkeys producing requesting gestures without explicit training by humans (controls). These results may open a window on the developmental mechanisms (i.e. incidental learning vs. training) underpinning gestural intentional communication in primates.

  5. Complement inhibition decreases early fibrogenic events in the lung of septic baboons

    Science.gov (United States)

    Silasi-Mansat, Robert; Zhu, Hua; Georgescu, Constantin; Popescu, Narcis; Keshari, Ravi S; Peer, Glenn; Lupu, Cristina; Taylor, Fletcher B; Pereira, Heloise Anne; Kinasewitz, Gary; Lambris, John D; Lupu, Florea

    2015-01-01

    Acute respiratory distress syndrome (ARDS) induced by severe sepsis can trigger persistent inflammation and fibrosis. We have shown that experimental sepsis in baboons recapitulates ARDS progression in humans, including chronic inflammation and long-lasting fibrosis in the lung. Complement activation products may contribute to the fibroproliferative response, suggesting that complement inhibitors are potential therapeutic agents. We have been suggested that treatment of septic baboons with compstatin, a C3 convertase inhibitor protects against ARDS-induced fibroproliferation. Baboons challenged with 109 cfu/kg (LD50) live E. coli by intravenous infusion were treated or not with compstatin at the time of challenge or 5 hrs thereafter. Changes in the fibroproliferative response at 24 hrs post-challenge were analysed at both transcript and protein levels. Gene expression analysis showed that sepsis induced fibrotic responses in the lung as early as 24 hrs post-bacterial challenge. Immunochemical and biochemical analysis revealed enhanced collagen synthesis, induction of profibrotic factors and increased cell recruitment and proliferation. Specific inhibition of complement with compstatin down-regulated sepsis-induced fibrosis genes, including transforming growth factor-beta (TGF-β), connective tissue growth factor (CTGF), tissue inhibitor of metalloproteinase 1 (TIMP1), various collagens and chemokines responsible for fibrocyte recruitment (e.g. chemokine (C-C motif) ligand 2 (CCL2) and 12 (CCL12)). Compstatin decreased the accumulation of myofibroblasts and proliferating cells, reduced the production of fibrosis mediators (TGF-β, phospho-Smad-2 and CTGF) and inhibited collagen deposition. Our data demonstrate that complement inhibition effectively attenuates collagen deposition and fibrotic responses in the lung after severe sepsis. Inhibiting complement could prove an attractive strategy for preventing sepsis-induced fibrosis of the lung. PMID:26337158

  6. Acute Lung Injury and Fibrosis in a Baboon Model of Escherichia coli Sepsis

    Science.gov (United States)

    Keshari, Ravi S.; Silasi-Mansat, Robert; Zhu, Hua; Popescu, Narcis I.; Peer, Glenn; Chaaban, Hala; Lambris, John D.; Polf, Holly; Lupu, Cristina; Kinasewitz, Gary

    2014-01-01

    Sepsis-induced inflammation of the lung leads to acute respiratory distress syndrome (ARDS), which may trigger persistent fibrosis. The pathology of ARDS is complex and poorly understood, and the therapeutic approaches are limited. We used a baboon model of Escherichia coli sepsis that mimics the complexity of human disease to study the pathophysiology of ARDS. We performed extensive biochemical, histological, and functional analyses to characterize the disease progression and the long-term effects of sepsis on the lung structure and function. Similar to humans, sepsis-induced ARDS in baboons displays an early inflammatory exudative phase, with extensive necrosis. This is followed by a regenerative phase dominated by proliferation of type 2 epithelial cells, expression of epithelial-to-mesenchymal transition markers, myofibroblast migration and proliferation, and collagen synthesis. Baboons that survived sepsis showed persistent inflammation and collagen deposition 6–27 months after the acute episodes. Long-term survivors had almost double the amount of collagen in the lung as compared with age-matched control animals. Immunostaining for procollagens showed persistent active collagen synthesis within the fibroblastic foci and interalveolar septa. Fibroblasts expressed markers of transforming growth factor-β and platelet-derived growth factor signaling, suggesting their potential role as mediators of myofibroblast migration and proliferation, and collagen deposition. In parallel, up-regulation of the inhibitors of extracellular proteases supports a deregulated matrix remodeling that may contribute to fibrosis. The primate model of sepsis-induced ARDS mimics the disease progression in humans, including chronic inflammation and long-lasting fibrosis. This model helps our understanding of the pathophysiology of fibrosis and the testing of new therapies. PMID:24066737

  7. Barrier and uptake mechanisms in the cerebrovascular response to noradrenaline. [/sup 133/Xe tracer technique, baboons

    Energy Technology Data Exchange (ETDEWEB)

    McCalden, T.A.; Eidelman, B.H.; Mendelow, A.D.

    1977-10-01

    Cerebral blood flow (CBF) was measured in 20 baboons by the intra-arterial xenon-133 injection method. The CBF responses to intra-arterial infusions of noradrenaline (NA) were determined. These responses were normally found to be vasodilator and mediated by beta adrenoreceptors. After infusion of substances blocking extraneuronal uptake of NA or opening of the blood-brain barrier, this vasodilation was either abolished or converted to an alpha-receptor mediated vasoconstriction. This suggests that normally the cerebral circulation is protected against noradrenergic vasoconstriction by mechanisms reducing the concentration of NA in the tunica media to below threshold for alpha-adrenoreceptor stimulation.

  8. Immunization of baboons with attenuated schistosomula of Schistosoma haematobium: levels of protection induced by immunization with larvae irradiated with 20 and 60 krad.

    Science.gov (United States)

    Harrison, R A; Bickle, Q D; Kiare, S; James, E R; Andrews, B J; Sturrock, R F; Taylor, M G; Webbe, G

    1990-01-01

    We have shown previously that baboons (Papio anubis) develop high levels (greater than 80%) of protection against challenge infection following immunization with Schistosoma haematobium cercariae irradiated with 20 krad. In the present study baboons were immunized with schistosomula irradiated with either 20 krad or 60 krad, with variations in the timing and number of larvae comprising each vaccination. Baboons immunized 2 or 3 times with schistosomula irradiated with 20 krad were significantly more protected (85-90%) against challenge infection than baboons similarly immunized with larvae receiving 60 krad (56-50% protection). Baboons immunized with schistosomula irradiated with 20 krad were better protected against challenge infection at 8 weeks after immunization than at 28 weeks after immunization. Protection was manifest by a reduction in worm numbers, tissue and excreta egg counts, gross pathology and, to a lesser extent, by stability of body weight and haematological indices following challenge. Enzyme-linked immunosorbent assay (ELISA) results of selected baboon sera showed few differences related to irradiation dose alone, but titres were higher in baboons receiving booster immunizations, and there was a significant correlation between titres immediately preceding challenge and the degree of resistance. Examination of responses to individual schistosomular surface antigens by immunoprecipitation and sodium dodecyl sulphate-polyacrylamide gel electrophoresis showed no correlation between the pattern of antigens recognized and resistance status. As with the ELISA assay, an anamnestic response was detected after vaccination, while the amount of antibody present declined markedly with increasing time after individual immunizations.

  9. Monkey Management: Using Spatial Ecology to Understand the Extent and Severity of Human-Baboon Conflict in the Cape Peninsula, South Africa

    Directory of Open Access Journals (Sweden)

    Tali S. Hoffman

    2012-09-01

    Full Text Available Conflict with humans poses one of the greatest threats to the persistence and survival of all wildlife. In the Cape Peninsula, South Africa, human-baboon conflict levels remain high despite substantial investment by conservation authorities in a variety of mitigation measures. Here we explore how spatial ecology can inform wildlife managers on the extent and severity of both current and projected human-baboon conflict. We apply conservative and generous densities - 2.3 and 5.9 baboons/km2 - to hypothetical landscape management scenarios to estimate whether the chacma baboon (Papio ursinus population in the Cape Peninsula is currently overabundant. We correlate conflict indices with spatial variables to explain intertroop differences in conflict levels. We investigate how an understanding of key elements of baboon ecology, including sleeping-site characteristics and intertroop territoriality, can direct management efforts and mitigate conflict. Our findings suggest that the current population of 475 baboons is below even the most conservative density estimate and that the area could potentially sustain up to 799 baboons. Conflict levels correlated positively with the loss of access to low-lying land through habitat transformation (Pearson r = 0.77, p = 0.015, n = 9 troops, and negatively with the distance of sleeping sites from the urban edge (Pearson r = 0.81, p = 0.001, n = 9 troops. Despite the availability of suitable sleeping sites elsewhere, more than half of all troops slept

  10. EXTRACORPOREAL CIRCULATION: EFFECT OF LONG-TERM (24-HOUR) CIRCULATION ON BLOOD COMPONENTS

    OpenAIRE

    Solberg, Robert Glen

    2010-01-01

    Extracorporeal circulation damages blood and causes harmful side effects such as stroke and/or systemic inflammatory response in patients. Reactions of blood components to extracorporeal circulation include complement and inflammatory reactions, coagulation and thrombogenesis, frank hemolysis, and platelet activation and adhesion to the extracorporeal circuit. Non-physiologic pressure and flow produced by blood pumps contribute to blood injury. Two pump types, roller and centrifugal, are u...

  11. EKSTRAKORPOREAL ŞOK DALGA TEDAVİSİ/EXTRACORPOREAL SHOCK WAVE THERAPY

    OpenAIRE

    2014-01-01

    Extracorporeal shock wave therapyExtracorporeal shock wave therapy (ESWT) is a therapy method which is applied acoustic pressure to thebody. Shock wave was first used in urology for renal stones in 1980s. Research has been started in orthopedicsin 1990s. Today it has been used for most of the diagnosis in different clinics. In this review it has summarizedthat the action mechanism, indications, contraindications, complications and current studies in the literatureabout extracorporeal shock wa...

  12. Analgesic effect of extracorporeal shock wave therapy versus ultrasound therapy in chronic tennis elbow

    OpenAIRE

    2015-01-01

    [Purpose] This study compared the analgesic effects of extracorporeal shock wave therapy with those of ultrasound therapy in patients with chronic tennis elbow. [Subjects] Fifty patients with tennis elbow were randomized to receive extracorporeal shock wave therapy or ultrasound therapy. [Methods] The extracorporeal shock wave therapy group received 5 treatments once per week. Meanwhile, the ultrasound group received 10 treatments 3 times per week. Pain was assessed using the visual analogue ...

  13. [Experience in the treatment of severe forms of sepsis by extracorporeal therapy and hyperbaric oxygenation].

    Science.gov (United States)

    Zhidkov, K P; Klechikov, V Z; Bogatyr', M N

    1997-01-01

    The results of multiple modality treatment of 81 patients with sepsis complicated by multiple organ failure are assessed. In 40 patients the traditional therapy of sepsis was supplemented with extracorporeal methods (hemoperfusion, autotransfusion of UV-exposed blood, and perfusion of xenospleen slices) and hyperbaric oxygenation (HBO) sessions. In the patients treated traditionally the mortality was 94%, whereas addition of extracorporeal treatment and HBO decreased this value to 40%. Hence, extracorporeal treatment and HBO are recommended for the treatment of sepsis.

  14. Management of Anesthesia under Extracorporeal Cardiopulmonary Support in an Infant with Severe Subglottic Stenosis.

    Science.gov (United States)

    Soeda, Rie; Taniguchi, Fumika; Sawada, Maiko; Hamaoka, Saeko; Shibasaki, Masayuki; Nakajima, Yasufumi; Hashimoto, Satoru; Sawa, Teiji; Nakayama, Yoshinobu

    2016-01-01

    A 4-month-old female infant who weighed 3.57 kg with severe subglottic stenosis underwent tracheostomy under extracorporeal cardiopulmonary support. First, we set up extracorporeal cardiopulmonary support to the infant and then successfully intubated an endotracheal tube with a 2.5 mm inner diameter before tracheostomy by otolaryngologists. Extracorporeal cardiopulmonary support is an alternative for maintenance of oxygenation in difficult airway management in infants.

  15. Management of Anesthesia under Extracorporeal Cardiopulmonary Support in an Infant with Severe Subglottic Stenosis

    Directory of Open Access Journals (Sweden)

    Rie Soeda

    2016-01-01

    Full Text Available A 4-month-old female infant who weighed 3.57 kg with severe subglottic stenosis underwent tracheostomy under extracorporeal cardiopulmonary support. First, we set up extracorporeal cardiopulmonary support to the infant and then successfully intubated an endotracheal tube with a 2.5 mm inner diameter before tracheostomy by otolaryngologists. Extracorporeal cardiopulmonary support is an alternative for maintenance of oxygenation in difficult airway management in infants.

  16. A CLINICAL EXPERIENCE OF USING EXTRACORPOREAL CYTOKINE ADSORPTION DEVICE (CYTOSORB ® IN A CASE OF DENGUE FEVER

    Directory of Open Access Journals (Sweden)

    Zafer A. Khan

    2016-10-01

    Full Text Available BACKGROUND Dengue is a mosquito-borne viral disease transmitted by Aedes aegypti and Aedes albopictus. It is hypothesised that elevated cytokines such as tumour necrosis factor alpha (TNF-α, interleukins and interferon gamma (IFN-γ during severe dengue causes damage to the endothelial cells of the capillaries that results in fluid leakage. A novel Extracorporeal Cytokine Adsorption Device (ECAD CytoSorb ® targets the cytokines helps modulate immune response and prevent multiorgan dysfunction syndrome. MATERIALS AND METHODS We report a case of dengue fever with septic shock and multiorgan failure admitted in the intensive care. He was treated with standard of care along with mechanical ventilation and renal replacement therapy. A novel ECAD CytoSorb was used as an adjuvant supportive therapy. The patient also received multiple transfusions to address thrombocytopenia and coagulopathy. RESULTS The patient showed gradual improvement. The patient showed normalised central nervous system function, improved oxygenation status, adequate renal function and normal platelet count at the time of discharge. The liver function had also improved significantly. CONCLUSION Extracorporeal Cytokine Adsorption device CytoSorb ® might be useful option as an adjuvant therapy in dengue patients with MODS.

  17. Experimental modified orthotopic piggy-back liver autotransplantation

    Energy Technology Data Exchange (ETDEWEB)

    Roveda, L. [Oncologic Surgery, Cancer Center of Excellence Fond. ' T.Campanella' , Europa Avenue, Catanzaro CZ-88100 (Italy)], E-mail: roveda.l@libero.it; Zonta, A. [Department of Surgery, University of Pavia, PV 27100 (Italy); Staffieri, F. [Veterinary Surgery Unit, Department of Emergencies and Organs Transplantation, Faculty of Veterinary Medicine, SP per Casamassima km 3, Valenzano, BA 70010 (Italy); Timurian, D.; DiVenere, B. [Surgery ' Madonna delle Grazie' Hospital, Contrada Cattedra Ambulante, Matera, MT 75100 (Italy); Bakeine, G.J. [Laboratorio Nazionale di Tecnologie Avanzate e Nanoscienza (TASC), Basovizza, TR (Italy); Crovace, A. [Veterinary Surgery Unit, Department of Emergencies and Organs Transplantation, Faculty of Veterinary Medicine, SP per Casamassima km 3, Valenzano, BA 70010 (Italy); Prati, U. [Oncologic Surgery, Cancer Center of Excellence Fond. ' T.Campanella' , Europa Avenue, Catanzaro CZ-88100 (Italy)

    2009-07-15

    The classical orthotopic liver autotransplantation is a very challenging and time wasting technique; it includes the division of major hepatic vessels and choledocus, and subsequent reconnection by end to end anastomoses. The caval end to end anastomoses are the most difficult to be performed and the interposition of a prosthesis can be required. We adopted the classical orthotopic liver autotransplantation technique in 2 patients affected with diffused liver metastases from colorectal cancer, for extracorporeal neutron capture therapy (BNCT). The procedure required very long operating times and the extracorporeal circulation (ECC) set up; furthermore the vena cava reconstruction was performed by the interposition of a goretex-prosthesis. We propose a 'modified orthotopic piggy-back technique' to simplify liver reconnection and shorten the operating time. Materials and methods: The technique was developed in the swine (25 kg body weight), under general anaesthesia. We performed the resection of the retro-hepatic vena cava with preservation of the caval flow during the anhepatic phase, by interposing a goretex-prosthesis. The reconstruction of the vena cava was then performed by a side-to-side cava-prosthesis anastomosis with lateral clamping of the prosthesis. The procedure was then completed according to the classical technique of liver transplantation. Results: The mean time for VC reconstruction was 56 ({+-}10) min. and the mean time for side-to-side VC-prosthesis anastomosis was 13 ({+-}4) min. Conclusions: The 'modified orthotopic piggy-back technique' can simplify the reimplant of the liver during autotransplantation and shorten the operating time. Furthermore also the time of total extracorporeal circulation is reduced, as during the anhepatic phase and during the side-to-side cava-prosthesis anastomosis the flow in the inferior vena cava is uninterrupted.

  18. Immunohistochemical localisation of TRA-1-60, TRA-1-81, GCTM-2 and podocalyxin in the developing baboon kidney.

    Science.gov (United States)

    Gubhaju, Lina; Laslett, Andrew; Bertram, John F; Zulli, Anthony; Black, M Jane

    2008-05-01

    The baboon is an ideal animal model to study human kidney development. The aim of the current study was to use immunohistochemistry to localise the antigens TRA-1-60, TRA-1-81, GCTM-2 and podocalyxin in the developing baboon kidney where nephrogenesis was still on-going and in kidneys where nephrogenesis was complete. Fixed kidney sections from baboons delivered at 125, 140, 175 and 185 days gestation (term = 185 days) were immuno-labelled with antibodies directed against TRA-1-60, TRA-1-81, GCTM-2 and podocalyxin. In kidneys with on-going nephrogenesis (125 and 140 days gestation), TRA-1-60, TRA-1-81 and GCTM-2 were specifically localised to the apical plasma membrane of the epithelium of the ureteric ampullae and the collecting ducts, while podocalyxin immunostaining was not detected. In kidneys where nephrogenesis was complete (175 and 185 days gestation) localisation of these markers was again very specifically localised to the collecting ducts. In conclusion, although further experimentation is required to confirm the identity of the specific cell types marked by these antibodies, this study provides new insight into the distribution of commonly utilised stem cell antibodies in the developing baboon kidney.

  19. Endogenous type C viral gene expression in cultures of fetal diploid baboon cells treated with 5'-bromodeoxyuridine

    Energy Technology Data Exchange (ETDEWEB)

    Lavelle, G.; Kennel, S.J.; Foote, L.J.

    1981-04-30

    Cultures of fetal diploid baboon fibroblasts treated with 5-bromodeoxyuridine synthesized protein antigenically related to baboon endogenous type C viral gag gene product, p28. Radioimmunoassays detected p28 antigenic specificities indistinguishable from those of purified virus. However, viral RNA-dependent DNA polymerase was not detected in culture fluids, and infectious virus was rarely recovered by cocultivation with susceptible heterologous cells. Extracellular particles containing p28 were not readily detected, further indicating that viral gag gene-coded proteins were synthesized independently of whole virus. Normal cultures of the same baboon cells exhibited endogenous expression of a glycoprotein antigenically related to BEV gp70, suggesting differential regulation of the endogenous gag and env gene-coded products. Baboon cell cultures exogenously infected with BEV produced extracellular particles having viral p28 and gp70 as measured by radioimmunoassays of culture fluids. Since induced cultures have about 10% positive cells versus close to 100% for infected culture, the amount of p28 per producing cell was about the same in both cell populations.

  20. Other better versus self better in baboons: an evolutionary approach of social comparison.

    Science.gov (United States)

    Dumas, F; Fagot, J; Davranche, K; Claidière, N

    2017-05-31

    Comparing oneself with others is an important characteristic of human social life, but the link between human and non-human forms of social comparison remains largely unknown. The present study used a computerized task presented in a social context to explore psychological mechanisms supporting social comparison in baboons and compare major findings with those usually observed in humans. We found that the effects of social comparison on subject's performance were guided both by similarity (same versus different sex) and by task complexity. Comparing oneself with a better-off other (upward comparison) increased performance when the other was similar rather than dissimilar, and a reverse effect was obtained when the self was better (downward comparison). Furthermore, when the other was similar, upward comparison led to a better performance than downward comparison. Interestingly, the beneficial effect of upward comparison on baboons' performance was only observed during simple task. Our results support the hypothesis of shared social comparison mechanisms in human and non-human primates. © 2017 The Author(s).

  1. Canine length in wild male baboons: maturation, aging and social dominance rank.

    Science.gov (United States)

    Galbany, Jordi; Tung, Jenny; Altmann, Jeanne; Alberts, Susan C

    2015-01-01

    Canines represent an essential component of the dentition for any heterodont mammal. In primates, like many other mammals, canines are frequently used as weapons. Hence, tooth size and wear may have significant implications for fighting ability, and consequently for social dominance rank, reproductive success, and fitness. We evaluated sources of variance in canine growth and length in a well-studied wild primate population because of the potential importance of canines for male reproductive success in many primates. Specifically, we measured maxillary canine length in 80 wild male baboons (aged 5.04-20.45 years) from the Amboseli ecosystem in southern Kenya, and examined its relationship with maturation, age, and social dominance rank. In our analysis of maturation, we compared food-enhanced baboons (those that fed part time at a refuse pit associated with a tourist lodge) with wild-feeding males, and found that food-enhanced males achieved long canines earlier than wild-feeding males. Among adult males, canine length decreased with age because of tooth wear. We found some evidence that, after controlling for age, longer canines were associated with higher adult dominance rank (accounting for 9% of the variance in rank), but only among relatively high-ranking males. This result supports the idea that social rank, and thus reproductive success and fitness, may depend in part on fighting ability mediated by canine size.

  2. Behavioral measurement of temperament in male nursery-raised infant macaques and baboons.

    Science.gov (United States)

    Heath-Lange, S; Ha, J C; Sackett, G P

    1999-01-01

    We define temperament as an individual's set of characteristic behavioral responses to novel or challenging stimuli. This study adapted a temperament scale used with rhesus macaques by Schneider and colleagues [American Journal of Primatology 25:137-155, 1991] for use with male pigtailed macaque (Macaca nemestrina, n = 7), longtailed macaque (M. fascicularis, n = 3), and baboon infants (Papio cynocephalus anubis, n = 4). Subjects were evaluated twice weekly for the first 5 months of age during routine removal from their cages for weighing. Behavioral measures were based on the subject's interactions with a familiar human caretaker and included predominant state before capture, response to capture, contact latency, resistance to tester's hold, degree of clinging, attention to environment, defecation/urination, consolability, facial expression, vocalizations, and irritability. Species differences indicated that baboons were more active than macaques in establishing or terminating contact with the tester. Temperament scores decreased over time for the variables Response to Capture and Contact Latency, indicating that as they grew older, subjects became less reactive and more bold in their interactions with the tester. Temperament scores changed slowly with age, with greater change occurring at younger ages. The retention of variability in reactivity between and within species may be advantageous for primates, reflecting the flexibility necessary to survive in a changing environment.

  3. Pathology resulting from the administration of a live attenuated anti-Schistosoma haematobium vaccine in baboons.

    Science.gov (United States)

    Byram, J E; Harrison, R A; von Lichtenberg, F; Webbe, G; Sturrock, R F

    1989-01-01

    Baboons (Papio anubis) were injected in the leg muscle with 18,000 20 Krad irradiated schistosomula of Schistosoma haematobium. Four protocols were followed: single, primary injection; single injection into animals primed by patent S. haematobium infection; secondary vaccine injection following an earlier injection; and single injection following praziquantel treatment of infected animals. Injection of the putative vaccine elicited localized mixed inflammatory infiltration at the site of injection which was both intense and prolonged. Three grades of tissue reaction were seen: the relatively mild primary response; the response in infected animals which had enhanced tissue eosinophilia; and the response in animals primed by prior injection and drug-treated prior infection. The latter 2 showed intensification of eosinophilia, stellate abscesses in the lesion centers, and perischistosomular Hoeppli precipitates. Intramuscular lesions peaked at 14 days for the primary response and at 7 days for all secondary responses. Traces of the milder lesions persisted beyond 4 weeks; more severe reactions healed more rapidly. Some schistosomula survived for 14 days in the milder reactions. A few larvae were deposited in the skin by backflushing of the injectate which produced local inflammation. Compared to mice, live schistosome vaccines injected into baboons elicited greater local inflammation; however, while evidence suggested that sporadic vaccine schistosomula did reach the lymphatic nodes draining the injection sites, no systemic lesions were found and the injection sites healed in approximately 5-6 weeks without permanent damage.

  4. Cardiac output by Doppler echocardiography in the premature baboon: comparison with radiolabeled microspheres.

    Science.gov (United States)

    Kinsella, J P; Morrow, W R; Gerstmann, D R; Taylor, A F; deLemos, R A

    1991-04-01

    Pulsed-Doppler echocardiography (PDE) is a useful noninvasive method for determining left ventricular output (LVO). However, despite increasingly widespread use in neonatal intensive care units, validation studies in prematures with cardiopulmonary disease are lacking. The purpose of this study was to compare radiolabeled microsphere (RLM) and PDE measurements of LVO, using the critically ill premature baboon as a model of the human neonate. Twenty-two paired RLM and PDE measurements of LVO were obtained in 14 animals between 3 and 24 h of age. Average PDE LVO was 152 ml/min/kg (range, 40-258 ml/min/kg) compared to 158 ml/min/kg (range, 67-278 ml/min/kg) measured by RLM. Linear regression analysis of the paired measurements showed good correlation with a slope near unity (gamma = 0.94x + 4.20, r = 0.91, SEE = 25.7 ml). We conclude that PDE determinations of LVO compare well with those measured by RLM in the premature baboon. PDE appears to provide a valid estimate of LVO and should be useful in human prematures with cardiopulmonary distress.

  5. CM 40907: a structurally novel anticonvulsant in mice, rats and baboons

    Energy Technology Data Exchange (ETDEWEB)

    Chambon, J.P.; Brochard, J.; Hallot, A.; Heaulme, M.; Brodin, R.; Roncucci, R.; Biziere, K.

    1985-06-01

    CM 40907 (3-(4-hydroxypiperidyl)-6-(2'-chlorophenyl)-pyridazine) is a chemically original compound which possesses the pharmacological properties of a potent, p.o. active anticonvulsant. The anticonvulsant activity of CM 40907 was examined in mice, rats and photosensitive Papio-papio baboons and compared to that of phenobarbital, diphenylhydantoin, carbamazepine, sodium valproate and ethosuximide. In mice, CM 40907 antagonized electroconvulsive shock and chemically induced seizures with an overall potency comparable to that of carbamazepine and a therapeutic ratio (ED50 rotorod/ED50 electroshock) superior to that of ethosuximide, sodium valproate, phenobarbital and carbamazepine. In the rat CM 40907 suppressed completed kindled amygdaloid seizures and was approximately as active as phenobarbital. In naturally photosensitive Senegalese Papio-papio baboons CM 40907 antagonized myoclonus and cortical paroxysmal discharges. In this model CM 40907 was approximately one-fourth as potent as phenobarbital, twice as potent as carbamazepine and 6 times more potent than sodium valproate. In mice CM 40907, at anticonvulsant doses, increased the affinity of (/sup 3/H)flunitrazepam for its central receptor site. Based on these results it is postulated that CM 40907 is a potent and relatively nonsedative anticonvulsant and may be of therapeutic benefit in epileptic disorders.

  6. Effect of water or saline intake on heat-induced limb vasodilation in dehydrated baboons.

    Science.gov (United States)

    Ryan, K L; Proppe, D W

    1990-02-01

    Dehydration markedly attenuates the increase in hindlimb blood flow elicited by environmental heating (EH) in baboons. This study sought to determine the importance of gradually produced increases in body fluid osmolality and decreases in body fluid volume in producing this attenuation. The hindlimb blood flow increases during EH of seven unanesthetized chronically instrumented baboons were examined during euhydration, dehydration (64-68 h of water deprivation), and after ad libitum oral rehydration with either water or a hyperosmotic saline solution. EH consisted of acute exposure to ambient temperatures of 38-42 degrees C until internal temperature reached 39.5 degrees C. Dehydration depressed the maximal external iliac artery blood flow (MIBF) and iliac vascular conductance (IVC) attained during EH in the euhydrated state by 37 and 43%, respectively. Rehydration with either water or saline solution, however, restored maximal MIBF and IVC to euhydrated levels. Because plasma osmolality remained at dehydrated levels after rehydration with saline, hyperosmolality does not produce the dehydration-induced attenuation in hindlimb blood flow.

  7. Effects of hyperosmolality and diuretics on heat-induced limb vasodilation in baboons.

    Science.gov (United States)

    Proppe, D W

    1990-02-01

    Dehydration attenuates the increase in limb skin blood flow elicited by environmental heating (EH). This study sought to determine which of the two primary effects of dehydration, increased body fluid osmolality or decreased body fluid volume, was primarily responsible for this cutaneous vasoconstrictor bias in baboons. Unanesthetized chronically instrumented baboons were exposed to EH while in euhydrated state, after 65-69 h of water deprivation (dehydration), after infusion of a small volume of hypertonic (20%) saline to raise plasma osmolality and sodium concentration to dehydration levels, and after injections of the diuretic furosemide over a 64-h period to produce an isosmotic fall in extracellular fluid volume. EH consisted of an acute elevation of ambient temperature to 39.5-42.0 degrees C until internal temperature reached 39.5-39.8 degrees C. The normal increases in external iliac artery blood flow and iliac vascular conductance during EH were unchanged by hyperosmolality but were attenuated by 39 and 31%, respectively, after furosemide treatment and by 42 and 46%, respectively, during dehydration. Thus the fall in extracellular fluid volume is the component of dehydration that attenuates the increase in hindlimb blood flow during EH in the same way as dehydration itself.

  8. alpha-Adrenergic control of intestinal circulation in heat-stressed baboons.

    Science.gov (United States)

    Proppe, D W

    1980-05-01

    The mechanisms involved in producing intestinal vasoconstriction during a hyperthermia-producing intestinal vasoconstriction during a hyperthermia-producing environmental heat stress are unknown. Five conscious baboons (Papio anubis), each with chronically implanted catheters and a flow probe around the superior mesenteric artery, were subjected to environmental heating (Ta 40-45 degrees C) to raise their arterial blood temperature (Tbl) 2.0-2.6 degrees C to approximately 39.5 degrees C. Accompanying the gradual rise in Tbl was a fall in mean superior mesenteric artery blood flow (MSMF) and a progressive rise in superior mesenteric vascular resistance (SMR). At peak Tbl, MSMF had fallen 28.8 +/- 0.6% (mean +/- SE) and SMR had risen 50.2 +/- 4.2%. To determine the involvement of the sympathetic nervous system in producing this intestinal vasoconstriction, the baboon was subjected to environmental heating after induction of alpha-adrenergic receptor blockade by phenoxybenzamine or phentolamine. In this state, the rise in Tbl was accompanied by no change in MSMF and a slight, but not statistically significant, rise (7.8 +/- 3.8%) in SMR. Since alpha-receptor blockade nearly completely abolishes intestinal vasoconstriction during heat stress, this intestinal vasoconstriction must be mediated primarily by elevated sympathetic outflow.

  9. Temporal dynamics of gene expression in the lung in a baboon model of E. coli sepsis

    Directory of Open Access Journals (Sweden)

    Zhu Hua

    2007-02-01

    Full Text Available Abstract Background Bacterial invasion during sepsis induces disregulated systemic responses that could lead to fatal lung failure. The purpose of this study was to relate the temporal dynamics of gene expression to the pathophysiological changes in the lung during the first and second stages of E. coli sepsis in baboons. Results Using human oligonucleotide microarrays, we have explored the temporal changes of gene expression in the lung of baboons challenged with sublethal doses of E. coli. Temporal expression pattern and biological significance of the differentially expressed genes were explored using clustering and pathway analysis software. Expression of selected genes was validated by real-time PCR. Cytokine levels in tissue and plasma were assayed by multiplex ELISA. Changes in lung ultrastructure were visualized by electron microscopy. We found that genes involved in primary inflammation, innate immune response, and apoptosis peaked at 2 hrs. Inflammatory and immune response genes that function in the stimulation of monocytes, natural killer and T-cells, and in the modulation of cell adhesion peaked at 8 hrs, while genes involved in wound healing and functional recovery were upregulated at 24 hrs. Conclusion The analysis of gene expression modulation in response to sepsis provides the baseline information that is crucial for the understanding of the pathophysiology of systemic inflammation and may facilitate the development of future approaches for sepsis therapy.

  10. Canine length in wild male baboons: maturation, aging and social dominance rank.

    Directory of Open Access Journals (Sweden)

    Jordi Galbany

    Full Text Available Canines represent an essential component of the dentition for any heterodont mammal. In primates, like many other mammals, canines are frequently used as weapons. Hence, tooth size and wear may have significant implications for fighting ability, and consequently for social dominance rank, reproductive success, and fitness. We evaluated sources of variance in canine growth and length in a well-studied wild primate population because of the potential importance of canines for male reproductive success in many primates. Specifically, we measured maxillary canine length in 80 wild male baboons (aged 5.04-20.45 years from the Amboseli ecosystem in southern Kenya, and examined its relationship with maturation, age, and social dominance rank. In our analysis of maturation, we compared food-enhanced baboons (those that fed part time at a refuse pit associated with a tourist lodge with wild-feeding males, and found that food-enhanced males achieved long canines earlier than wild-feeding males. Among adult males, canine length decreased with age because of tooth wear. We found some evidence that, after controlling for age, longer canines were associated with higher adult dominance rank (accounting for 9% of the variance in rank, but only among relatively high-ranking males. This result supports the idea that social rank, and thus reproductive success and fitness, may depend in part on fighting ability mediated by canine size.

  11. Knockouts of high-ranking males have limited impact on baboon social networks.

    Science.gov (United States)

    Franz, Mathias; Altmann, Jeanne; Alberts, Susan C

    Social network structures can crucially impact complex social processes such as collective behaviour or the transmission of information and diseases. However, currently it is poorly understood how social networks change over time. Previous studies on primates suggest that `knockouts' (due to death or dispersal) of high-ranking individuals might be important drivers for structural changes in animal social networks. Here we test this hypothesis using long-term data on a natural population of baboons, examining the effects of 29 natural knockouts of alpha or beta males on adult female social networks. We investigated whether and how knockouts affected (1) changes in grooming and association rates among adult females, and (2) changes in mean degree and global clustering coefficient in these networks. The only significant effect that we found was a decrease in mean degree in grooming networks in the first month after knockouts, but this decrease was rather small, and grooming networks rebounded to baseline levels by the second month after knockouts. Taken together our results indicate that the removal of high-ranking males has only limited or no lasting effects on social networks of adult female baboons. This finding calls into question the hypothesis that the removal of high-ranking individuals has a destabilizing effect on social network structures in social animals.

  12. Evidence for varying social strategies across the day in chacma baboons.

    Science.gov (United States)

    Sick, Claudia; Carter, Alecia J; Marshall, Harry H; Knapp, Leslie A; Dabelsteen, Torben; Cowlishaw, Guy

    2014-07-01

    Strong social bonds can make an important contribution to individual fitness, but we still have only a limited understanding of the temporal period relevant to the adjustment of social relationships. While there is growing recognition of the importance of strong bonds that persist for years, social relationships can also vary over weeks and months, suggesting that social strategies may be optimized over shorter timescales. Using biological market theory as a framework, we explore whether temporal variation in the benefits of social relationships might be sufficient to generate daily adjustments of social strategies in wild baboons. Data on grooming, one measure of social relationships, were collected from 60 chacma baboons (Papio ursinus) across two troops over a six month period. Our analyses suggest that social strategies can show diurnal variation, with subordinates preferentially grooming more dominant individuals earlier in the day compared with later in the day. These findings indicate that group-living animals may optimize certain elements of their social strategies over relatively short time periods.

  13. Liver Transplantation for Hepatic Trauma: A Study From the European Liver Transplant Registry.

    Science.gov (United States)

    Krawczyk, Marek; Grąt, Michał; Adam, Rene; Polak, Wojciech G; Klempnauer, Jurgen; Pinna, Antonio; Di Benedetto, Fabrizio; Filipponi, Franco; Senninger, Norbert; Foss, Aksel; Rufián-Peña, Sebastian; Bennet, William; Pratschke, Johann; Paul, Andreas; Settmacher, Utz; Rossi, Giorgio; Salizzoni, Mauro; Fernandez-Selles, Carlos; Martínez de Rituerto, Santiago T; Gómez-Bravo, Miguel A; Pirenne, Jacques; Detry, Olivier; Majno, Pietro E; Nemec, Petr; Bechstein, Wolf O; Bartels, Michael; Nadalin, Silvio; Pruvot, Francois R; Mirza, Darius F; Lupo, Luigi; Colledan, Michele; Tisone, Giuseppe; Ringers, Jan; Daniel, Jorge; Charco Torra, Ramón; Moreno González, Enrique; Bañares Cañizares, Rafael; Cuervas-Mons Martinez, Valentin; San Juan Rodríguez, Fernando; Yilmaz, Sezai; Remiszewski, Piotr

    2016-11-01

    Liver transplantation is the most extreme form of surgical management of patients with hepatic trauma, with very limited literature data supporting its use. The aim of this study was to assess the results of liver transplantation for hepatic trauma. This retrospective analysis based on European Liver Transplant Registry comprised data of 73 recipients of liver transplantation for hepatic trauma performed in 37 centers in the period between 1987 and 2013. Mortality and graft loss rates at 90 days were set as primary and secondary outcome measures, respectively. Mortality and graft loss rates at 90 days were 42.5% and 46.6%, respectively. Regarding general variables, cross-clamping without extracorporeal veno-venous bypass was the only independent risk factor for both mortality (P = 0.031) and graft loss (P = 0.034). Regarding more detailed factors, grade of liver trauma exceeding IV increased the risk of mortality (P = 0.005) and graft loss (P = 0.018). Moreover, a tendency above the level of significance was observed for the negative impact of injury severity score (ISS) on mortality (P = 0.071). The optimal cut-off for ISS was 33, with sensitivity of 60.0%, specificity of 80.0%, positive predictive value of 75.0%, and negative predictive value of 66.7%. Liver transplantation seems to be justified in selected patients with otherwise fatal severe liver injuries, particularly in whom cross-clamping without extracorporeal bypass can be omitted. The ISS cutoff less than 33 may be useful in the selection process.

  14. Effect of the antiestrogen ethamoxytriphetol (MER-25) on placental low density lipoprotein uptake and degradation in baboons

    Energy Technology Data Exchange (ETDEWEB)

    Henson, M.C.; Babischkin, J.S.; Pepe, G.J.; Albrecht, E.D.

    1988-05-01

    The present study determined if the decline in placental progesterone (P4) production that results from administration of the antiestrogen ethamoxytriphetol (MER-25) to pregnant baboons results from a change in placental low density lipoprotein (LDL) uptake and/or degradation. Pregnant baboons (Papio anubis) were untreated (n = 10) or received MER-25 (25 mg/kg BW, orally; n = 10) daily on days 140-170 of gestation (term, 184 days). Placentas were removed by cesarean section on day 170 of gestation, and villous tissue was dispersed with 0.1% collagenase at 37 C for 40 min. Placental cells (10(6)) were incubated in medium 199 (pH 7.2) for 12 h at 37 C with increasing amounts (5-100 micrograms) of (125I)LDL, with or without a 100-fold excess of unlabeled baboon LDL. Mean (+/- SE) peripheral serum P4 concentrations on days 140-170 of gestation were 51% lower (P less than 0.01) in MER-25-treated (5.7 +/- 0.3 ng/ml) than in untreated (11.6 +/- 0.5 ng/ml) baboons. The uptake of LDL was 56% lower (P less than 0.01) in placental cells from antiestrogen-treated (6.3 +/- 1.6 ng/micrograms cell protein) than in those from untreated (14.4 +/- 1.9 ng/micrograms cell protein) baboons. The dissociation constants for placental LDL uptake, as assessed by Scatchard analysis, however, were similar in untreated (0.80 microgram/ml) and MER-25-treated (0.76 microgram/ml) animals. The amount of (125I)LDL concomitantly degraded by cells from baboons that received MER-25 was 54% of that degraded by cells from untreated controls. The relative decline in LDL degradation by cells of antiestrogen-treated baboons was proportionate to the decline in overall LDL uptake. The results indicate, therefore, that antiestrogen treatment decreased the amount of placental LDL uptake, but did not change the affinity for the lipoprotein.

  15. Liver biopsy

    Science.gov (United States)

    Biopsy - liver; Percutaneous biopsy ... the biopsy needle to be inserted into the liver. This is often done by using ultrasound. The ... the chance of damage to the lung or liver. The needle is removed quickly. Pressure will be ...

  16. Liver Hemangioma

    Science.gov (United States)

    ... in your liver, even if it's a benign mass. There's no evidence that an untreated liver hemangioma can lead to liver ... of Nondiscrimination Advertising Mayo Clinic is a not-for-profit organization ...

  17. Dense pulmonary opacification in neonates treated with extracorporeal membrane oxygenation

    Energy Technology Data Exchange (ETDEWEB)

    Schlesinger, A.E.; Cornish, J.D.; Null, D.M.

    1986-09-01

    Chest radiographic findings in three neonates with respiratory failure secondary to meconium aspiration treated with extracorporeal membrane oxygenation (ECMO) are described. The degree of pulmonary opacification on the chest radiographs failed to correlate with the patients' clinical status as measured by the arterial oxygen levels but correlated well with the peak airway pressure (PAP) and continuous positive airway pressure (CPAP) settings on the mechanical ventilator. Because a variable portion of the arterial blood oxygenation is performed by the extracorporeal membrane oxygenator and unusually large fluctuations in airway pressure settings can occur in these patients while on ECMO, it is important to realize that the chest radiography may not be an accurate predictor of the patients' clinical status.

  18. Monitoring of the Adult Patient on Venoarterial Extracorporeal Membrane Oxygenation

    Directory of Open Access Journals (Sweden)

    Mabel Chung

    2014-01-01

    Full Text Available Venoarterial extracorporeal membrane oxygenation (VA ECMO provides mechanical support to the patient with cardiac or cardiopulmonary failure. This paper reviews the physiology of VA ECMO including the determinants of ECMO flow and gas exchange. The efficacy of this therapy may be determined by assessing patient hemodynamics and device flow, overall gas exchange support, markers of adequate oxygen delivery, and pulsatility of the arterial blood pressure waveform.

  19. Transportation of Critically Ill Patients on Extracorporeal Membrane Oxygenation

    OpenAIRE

    Broman, L. Mikael; Frenckner, Björn

    2016-01-01

    Extracorporeal membrane oxygenation (ECMO) may be a life-saving procedure for patients with severe reversible pulmonary or cardiac failure or for patients in need for a bridge to transplantation. ECMO is provided by specialized centers, but patients in need of ECMO are frequently taken care of at other centers. Conventional transports to an ECMO center can be hazardous and deaths have been described. For this reason, many ECMO centers have developed transport programs with mobile ECMO. After ...

  20. Severe myocardial injury and extracorporeal membrane oxygenation following perinatal asphyxia

    Directory of Open Access Journals (Sweden)

    P. Benson Ham

    2015-05-01

    Full Text Available Perinatal asphyxia is a common cause of morbidity and mortality in the newborn and is associated with myocardial injury in a significant proportion of cases. Biomarkers, echocardiography, and rhythm disturbances are sensitive indicators of myocardial ischemia and may predict mortality. We present a case of severe myocardial dysfunction immediately after delivery managed with extracorporeal membrane oxygenation (ECMO and discuss the role of cardiac biomarkers, echocardiography, electrocardiography, and ECMO in the asphyxiated newborn.

  1. Patient information leaflets for extracorporeal shock wave lithotripsy: questionnaire survey

    OpenAIRE

    Askari, A.; Shergill, I.

    2012-01-01

    Objectives To compare the level of information provided in extracorporeal shock wave lithotripsy (ESWL) patient information leaflets in the London and East of England Deaneries Design All trusts in the London and East of England Deanery who offer an ESWL service were contacted and leaflets were compared Setting London and East of England Deanery Participants Alan Askari, Iqbal Shergill Main outcome measures Examination of key information that was communicated to ESWL patients via leaflets Res...

  2. Kidney changes after extracorporeal shock wave lithotripsy; MR evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Yoshioka, Hiroyasu; Shindo, Hiroshi; Mabuchi, Nobuhisa; Kawakami, Akira; Fujii, Koichi; Hamada, Tatsumi; Ishida, Osamu; Umekawa, Toru; Kohri, Kenjiro (Kinki Univ., Osakasayama, Osaka (Japan). School of Medicine)

    1991-02-01

    MRI was performed before and after extracorporeal shock wave lithotripsy (ESWL) to determine the effects of ESWL on the kidney and perinephric tissues. Of the 40 kidneys studied, 24 showed one or more changes on MRI: loss of the corticomedullary junction (n=15), subcapsular fluid (n=14), subcapsular hematoma (n=1), thickening of bridging septa (n=8), high intensity area in the muscle (n=8). These relatively subtle changes detected on MRI may not be apparent with other imaging techniques. (author).

  3. Pediatric extracorporeal shock wave lithotripsy: Predicting successful outcomes.

    Science.gov (United States)

    McAdams, Sean; Shukla, Aseem R

    2010-10-01

    Extracorporeal shock wave lithotripsy (ESWL) is currently a first-line procedure of most upper urinary tract stones ionizing radiation, perhaps utilizing advancements in ultrasound and magnetic resonance imaging. This report provides a review of the current literature evaluating the patient attributes and stone factors that may be predictive of successful ESWL outcomes along with reviewing the role of pre-operative imaging and considerations for patient safety.

  4. Effectiveness of extracorporeal shockwave therapy in three major tendon diseases

    OpenAIRE

    Carulli, Christian; Tonelli, Filippo; Innocenti, Matteo; Gambardella, Bonaventura; Muncibì, Francesco; Innocenti, Massimo

    2015-01-01

    Background Extracorporeal shockwave therapy is a conservative treatment for several painful musculoskeletal disorders. The aim of the study was the assessment of the relief from pain by the shockwave therapy in a population of consecutive patients affected by specific pathologies. Materials and methods A group of consecutive patients were studied and treated. They were affected by calcific tendonitis of the shoulder (129 patients), chronic Achilles tendinopathy (102 patients), and lateral epi...

  5. Extracorporeal Shock Wave Therapy for Nonunion of the Tibia

    Science.gov (United States)

    2010-03-01

    Zoellner J, Nafe B. Shock wave therapy versus conventional surgery in the treatment of calcifying tendinitis of the shoulder. Clin Orrhop Relar Res. 200...I ;387:72-82. 26. Wang CJ, Yang KD, Wang FS. ct al. Shock wave therapy for culcific tendinitis of the shoulder: a prospective clinical study with...Selvi E, ct al. Extracorporeal shock wave therapy for chronic calcific tendinitis of the shoulder: single blind study. Ann Rheum Dis. 2(K13;62:248

  6. Opioid receptor imaging and displacement studies with [6-O-[{sup 11}C]methyl]buprenorphine in baboon brain

    Energy Technology Data Exchange (ETDEWEB)

    Galynker, Igor; Schlyer, David J.; Dewey, Stephen L.; Fowler, Joanna S.; Logan, Jean; Gatley, S. John; MacGregor, Robert R.; Ferrieri, Richard A.; Holland, M. J.; Brodie, Jonathan; Simon, Eric; Wolf, Alfred P

    1996-04-01

    Buprenorphine (BPN) is a mixed opiate agonist-antagonist used as an analgesic and in the treatment of opiate addiction. We have used [6-O-[{sup 11}C]methyl]buprenorphine ([{sup 11}C]BPN) to measure the regional distribution in baboon brain, the test-retest stability of repeated studies in the same animal, the displacement of the labeled drug by naloxone in vivo, and the tissue distribution in mice. The regional distribution of radioactivity in baboon brain determined with PET was striatum > thalamus > cingulate gyrus > frontal cortex > parietal cortex > occipital cortex > cerebellum. This distribution corresponded to opiate receptor density and to previously published data (37). The tracer uptake in adult female baboons showed no significant variation in serial scans in the same baboon with no intervention in the same scanning session. HPLC analysis of baboon plasma showed the presence of labeled metabolites with 92% {+-} 2.2% and 43% {+-} 14.4% of the intact tracer remaining at 5 and 30 min, respectively. Naloxone, an opiate receptor antagonist, administered 30-40 min after tracer injection at a dose of 1.0 mg/kg i.v., reduced [{sup 11}C]BPN binding in thalamus, striatum, cingulate gyrus, and frontal cortex to values 0.25 to 0.60 of that with no intervention. There were minimal (< 15%) effects on cerebellum. Naloxone treatment significantly reduced the slope of the Patlak plot in receptor-containing regions. These results demonstrate that [{sup 11}C]BPN can be displaced by naloxone in vivo, and they affirm the feasibility of using this tracer and displacement methodology for short-term kinetics studies with PET. Mouse tissue distribution data were used to estimate the radiation dosimetry to humans. The critical organ was the small intestine, with a radiation dose estimate to humans of 117 nrad/mCi.

  7. A 22-year experience in global transport extracorporeal membrane oxygenation.

    Science.gov (United States)

    Coppola, Christopher P; Tyree, Melissa; Larry, Karen; DiGeronimo, Robert

    2008-01-01

    Transport extracorporeal membrane oxygenation (ECMO) is currently available at 12 centers. We report a 22-year experience from the only facility providing global transport ECMO. Indications for transport ECMO include lack of ECMO services, inability to transport conventionally, inability to wean from cardiopulmonary bypass, extracorporeal cardiopulmonary resuscitation, and need to move a patient on ECMO for specialized services such as organ transplantation. Retrospective database review of children undergoing inhouse and transport ECMO from 1985 to 2007. Sixty-eight children underwent transport ECMO. Fifty-six were transported on ECMO into our facility. The remaining 12 were moved between 2 outside locations. Ground vehicles and fixed-wing aircraft were used. Distance transported was 8 to 7500 miles (13-12070 km), mean 1380 miles (2220 km). There were 116 inhouse ECMO runs. No child died during transport. Survival to discharge after transport ECMO was 65% (44/68) and, for inhouse ECMO, was 70% (81/116). Transport ECMO is feasible and effective, with survival rates comparable to inhouse ECMO. We have used transport ECMO to help children at non-ECMO centers with pulmonary failure who have not improved with inhaled nitric oxide and high-frequency ventilation. We have also transported a child after extracorporeal cardiopulmonary resuscitation, which may represent an emerging indication for transport ECMO. Transport ECMO often is the only option for children too unstable for conventional transport or those already on ECMO and requiring a specialized service at another facility, such as organ transplantation.

  8. Extracorporeal Membrane Oxygenation for the Support of a Potential Organ Donor with a Fatal Brain Injury before Brain Death Determination

    Directory of Open Access Journals (Sweden)

    Sung Wook Chang

    2016-05-01

    Full Text Available The shortage of available organ donors is a significant problem and various efforts have been made to avoid the loss of organ donors. Among these, extracorporeal membrane oxygenation (ECMO has been introduced to help support and manage potential donors. Many traumatic brain injury patients have healthy organs that might be eligible for donation for transplantation. However, the condition of a donor with a fatal brain injury may rapidly deteriorate prior to brain death determination; this frequently results in the loss of eligible donors. Here, we report the use of venoarterial ECMO to support a potential donor with a fatal brain injury before brain death determination, and thereby preserve donor organs. The patient successfully donated his liver and kidneys after brain death determination.

  9. Anti-GaL IgG antibodies in sera of newborn humans and baboons and its significance in pig xenotransplantation.

    Science.gov (United States)

    Minanov, O P; Itescu, S; Neethling, F A; Morgenthau, A S; Kwiatkowski, P; Cooper, D K; Michler, R E

    1997-01-27

    We have previously demonstrated that hyperacute rejection does not occur in a pig-to-newborn baboon heart transplant model, presumably because of low levels of cytotoxic antipig antibodies present in the serum of newborn baboons. Cytotoxic antipig antibodies are primarily directed to alpha-1,3-galactosyl (alpha Gal) residues on endothelial cell surface structures Twenty-one full-term humans and 5 full-term baboons were tested for complement mediated lysis (CML) of pig kidney (PK-15) cells and anti-alpha Gal activity with an ELISA using BSA-conjugated alpha Gal residues as target. To evaluate the significance of the anti-alpha Gal titers in vivo 5 newborn baboons underwent heterotopic pig cardiac xenotransplantation. Six of 21 human samples and 1 of 5 baboon samples demonstrated significant cytotoxicity to PK-15 cells. Twelve of 21 newborn humans had anti-alpha Gal IgG antibodies at titers of 1:80 or greater. None of the samples had anti-alpha Gal IgM. In newborn baboons, 1 of 5 sera had anti-alpha Gal IgG antibodies at titers greater than 1:80 and none of these samples had anti-alpha Gal IgM. Xenografts survived for an average of 3.6 days, even in the baboon with high anti-alpha Gal IgG titers. Analysis of the explanted grafts showed minimal evidence of complement-mediated hyperacute rejection (HAR), but prominent mononuclear cell infiltrates. In serum tested posttransplant there was an induced anti-alpha Gal response with cytotoxicity against PK-15 cells. These results show that anti-alpha Gal IgM is absent in newborn human and baboon sera, allowing pig grafts to avoid HAR. However, the presence of anti-alpha Gal IgG may be associated with mononuclear cell infiltration of the xenograft and its subsequent rejection.

  10. A note on the efficacy of a new class of compounds, 9-acridanone-hydrazones, against Schistosoma mansoni in a primate--the baboon.

    Science.gov (United States)

    Sturrock, R F; Otieno, M; James, E R; Webbe, G

    1985-01-01

    Five 9-acridanone-hydrazone compounds were tested against moderately heavy Schistosoma mansoni infections in baboons. They were administered as a single oral dose at a rate of 50 mg/kg body-weight. Compared with results from an untreated control baboon, four of the compounds showed high levels of activity judged by the reduction or elimination of faecal egg production, adult worms and tissue eggs.

  11. Significant reduction in blood loss in patients undergoing minimal extracorporeal circulation

    NARCIS (Netherlands)

    Gerritsen, W. B.; van Boven, W. J.; Smelt, M.; Morshuis, W. J.; van Dongen, H. P.; Haas, F. J.; Aarts, L. P.

    2006-01-01

    Several recent studies have shown differences in blood loss and allogeneic transfusion requirements between on-pump and off-pump coronary artery bypass grafting (CABG). Recently a new concept, the mini-extracorporeal circulation, was introduced to minimize the side effects of extracorporeal circulat

  12. Prospective longitudinal evaluation of lung function during the first year of life after extracorporeal membrane oxygenation

    NARCIS (Netherlands)

    Hofhuis, W.; Hanekamp, M.N.; Ijsselstijn, H.; Nieuwhof, E.M.; Hop, W.C.J.; Tibboel, D.; Jongste, J.C. de; Merkus, P.J.F.M.

    2011-01-01

    OBJECTIVE: To collect longitudinal data on lung function in the first year of life after extracorporeal membrane oxygenation and to evaluate relationships between lung function and perinatal factors. Longitudinal data on lung function in the first year of life after extracorporeal membrane oxygenati

  13. Two successful neonatal extracorporeal membrane oxygenation treatment for severe heart failure after cardiac surgery

    Institute of Scientific and Technical Information of China (English)

    TAN Lin-hua; DU Li-zhong; HE Xiao-jun; SUN Mei-yue; ZHANG Ze-wei; LIN Ru

    2009-01-01

    @@ Extracorporeal membrane oxygenation(ECMO)can play an important role by providing short-term circulatory support to enable myocardial recovery in patients with life-threatening heart failure.Currently,over 4000 children who received ECMO for cardiac support have been reported to the Extracorporeal Life Support Registry,with the majority of patients placed on ECMO following cardiac surgery.

  14. Analgesic effect of extracorporeal shock wave therapy versus ultrasound therapy in chronic tennis elbow.

    Science.gov (United States)

    Lizis, Paweł

    2015-08-01

    [Purpose] This study compared the analgesic effects of extracorporeal shock wave therapy with those of ultrasound therapy in patients with chronic tennis elbow. [Subjects] Fifty patients with tennis elbow were randomized to receive extracorporeal shock wave therapy or ultrasound therapy. [Methods] The extracorporeal shock wave therapy group received 5 treatments once per week. Meanwhile, the ultrasound group received 10 treatments 3 times per week. Pain was assessed using the visual analogue scale during grip strength evaluation, palpation of the lateral epicondyle, Thomsen test, and chair test. Resting pain was also recorded. The scores were recorded and compared within and between groups pre-treatment, immediately post-treatment, and 3 months post-treatment. [Results] Intra- and intergroup comparisons immediately and 3 months post-treatment showed extracorporeal shock wave therapy decreased pain to a significantly greater extent than ultrasound therapy. [Conclusion] Extracorporeal shock wave therapy can significantly reduce pain in patients with chronic tennis elbow.

  15. Liver regeneration.

    Science.gov (United States)

    Mao, Shennen A; Glorioso, Jaime M; Nyberg, Scott L

    2014-04-01

    The liver is unique in its ability to regenerate in response to injury. A number of evolutionary safeguards have allowed the liver to continue to perform its complex functions despite significant injury. Increased understanding of the regenerative process has significant benefit in the treatment of liver failure. Furthermore, understanding of liver regeneration may shed light on the development of cancer within the cirrhotic liver. This review provides an overview of the models of study currently used in liver regeneration, the molecular basis of liver regeneration, and the role of liver progenitor cells in regeneration of the liver. Specific focus is placed on clinical applications of current knowledge in liver regeneration, including small-for-size liver transplant. Furthermore, cutting-edge topics in liver regeneration, including in vivo animal models for xenogeneic human hepatocyte expansion and the use of decellularized liver matrices as a 3-dimensional scaffold for liver repopulation, are proposed. Unfortunately, despite 50 years of intense study, many gaps remain in the scientific understanding of liver regeneration.

  16. Neonatal Extracorporeal Membrane Oxygenation Devices, Techniques and Team Roles: 2011 Survey Results of the United States’ Extracorporeal Life Support Organization Centers

    OpenAIRE

    Lawson, Scott; Ellis, Cory; Butler, Katie; McRobb, Craig; Mejak, Brian

    2011-01-01

    In early 2011, surveys of active Extracorporeal Life Support Organization (ELSO) centers within the United States were conducted by electronic mail regarding neonatal Extracorporeal Membrane Oxygenation (ECMO) equipment and professional staff. Seventy-four of 111 (67%) U.S. centers listed in the ELSO directory as neonatal centers responded to the survey. Of the responding centers, 53% routinely used roller pumps for neonatal ECMO, 15% reported using centrifugal pumps and 32% reported using a ...

  17. Nicotine Blocks Brain Estrogen Synthase (Aromatase): In Vivo Positron Emission Tomography Studies in Female Baboons

    Energy Technology Data Exchange (ETDEWEB)

    Biegon, A.; Biegon, A.; Kim, S.-W.; Logan, J.; Hooker, J.M.; Muench, L.; Fowler, J.S.

    2010-01-12

    Cigarette smoking and nicotine have complex effects on human physiology and behavior, including some effects similar to those elicited by inhibition of aromatase, the last enzyme in estrogen biosynthesis. We report the first in vivo primate study to determine whether there is a direct effect of nicotine administration on brain aromatase. Brain aromatase availability was examined with positron emission tomography and the selective aromatase inhibitor [{sup 11}C]vorozole in six baboons before and after exposure to IV nicotine at .015 and .03 mg/kg. Nicotine administration produced significant, dose-dependent reductions in [{sup 11}C]vorozole binding. The amygdala and preoptic area showed the largest reductions. Plasma levels of nicotine and its major metabolite cotinine were similar to those found in cigarette smokers. Nicotine interacts in vivo with primate brain aromatase in regions involved in mood, aggression, and sexual behavior.

  18. The baboon (Papio anubis extracranial carotid artery: An anatomical guide for endovascular experimentation

    Directory of Open Access Journals (Sweden)

    Laufer Ilya

    2001-12-01

    Full Text Available Abstract Background As novel endovascular strategies are developed for treating neurological disease, there is an increasing need to evaluate these techniques in relevant preclinical models. The use of non-human primates is especially critical given their structural and physiological homology with humans. In order to conduct primate endovascular studies, a comprehensive understanding of the carotid anatomy is necessary. We therefore performed a detailed examination of the vessel lengths, lumen diameters and angles of origin of the baboon extracranial carotid system. Methods We characterized the extracranial carotid system often male baboons (Papio anubis, range 15.1–28.4 kg by early post-mortem dissection. Photographic documentation of vessel lengths, lumen diameters, and angles of origin were measured for each segment of the carotid bilaterally. Results The common carotid arteries averaged 94.7 ± 1.7 mm (left and 87.1 ± 1.6 mm (right in length. The average minimal common carotid lumen diameters were 3.0 ± 0.3 mm (left and 2.9 ± 0.2 mm (right. Each animal had a common brachiocephalic artery arising from the aorta which bifurcated into the left common carotid artery and right braciocephalic artery after 21.5 ± 1.6 mm. The vascular anatomy was found to be consistent among animals despite a wide range of animal weights. Conclusions The consistency in the Papio anubis extracranial carotid system may promote the use of this species in the preclinical investigation of neuro-interventional therapies.

  19. White monkey syndrome and presumptive copper deficiency in wild savannah baboons.

    Science.gov (United States)

    Markham, A Catherine; Gesquiere, Laurence R; Bellenger, Jean-Philippe; Alberts, Susan C; Altmann, Jeanne

    2011-11-01

    In immature wild savannah baboons (Papio cynocephalus), we observed symptoms consistent with copper (Cu) deficiency and, more specifically, with a disorder referred to as white monkey syndrome (WMS) in laboratory primates. The objectives of this study were to characterize this pathology, and test three hypotheses that (1) Cu deficiency may have been induced by zinc (Zn) toxicity, (2) it may have been induced by molybdenum (Mo) toxicity, and (3) cumulative rainfall during the perinatal period and particularly during gestation is an ecological factor distinguishing infants afflicted with WMS from non-WMS infants. During 2001-2009, we observed 22 instances of WMS out of a total 377 live births in the study population. Visible symptoms exhibited by WMS infants included whitening of the animal's fur and/or impaired mobility characterized by an apparent "stiffening" of the hindlimbs. Occurrence of WMS did not vary significantly by gender. However, among individuals that survived at least 180 days, WMS males had a significantly lower survivorship probability than non-WMS males. Zn/Cu ratios assessed from hair samples of adult female baboons were higher in females who had produced at least one WMS offspring relative to females who had not had a WMS offspring. This was true even when the hair sample was collected long after the birth of the female's afflicted infant. We consider this potentially indicative of a robust tendency for low Cu levels induced by elevated Zn intake in some individuals. No significant differences of Mo/Cu ratios were observed. Cumulative rainfall during gestation (∼179 days) was 50% lower for WMS infants relative to non-WMS infants. In contrast, rainfall for the two classes of infants did not differ in the 180 days before conception or in the 180 days following birth. This finding highlights the importance of prenatal ecological conditions in healthy fetal development with regard to WMS.

  20. Paternity alone does not predict long-term investment in juveniles by male baboons.

    Science.gov (United States)

    Moscovice, Liza R; Heesen, Marlies; Di Fiore, Anthony; Seyfarth, Robert M; Cheney, Dorothy L

    2009-08-01

    Adult male chacma baboons (Papio hamadryas ursinus) form preferential associations, or friendships, with particular lactating females. Males exhibit high levels of affiliative contact with their friends' infants and defend them from potentially infanticidal attacks (Palombit et al. 1997). Little is known about males' associations with juveniles once they have passed the period of infanticidal risk. We conducted an observational, experimental, and genetic study of adult male and juvenile chacma baboons in the Moremi Reserve, Botswana. We identified preferential associations between males and juveniles and used behavioral data and a playback experiment to explore whether those associations have potential fitness benefits for juveniles. We determined whether males preferentially invest in care of their own offspring. We also determined how often males invest in care of their former friends' offspring. The majority of juveniles exhibited preferential associations with one or two males, who had almost always been their mother's friend during infancy. However, in only a subset of these relationships was the male the actual father, in part because many fathers died or disappeared before their offspring were weaned. Male caretakers intervened on behalf of their juvenile associates in social conflicts more often than they intervened on behalf of unconnected juveniles, and they did not appear to differentiate between genetic offspring and unrelated associates. Playbacks of juveniles' distress calls elicited a stronger response from their caretakers than from control males. Chacma males may provide care to unrelated offspring of former friends because the costs associated with such care are low compared with the potentially high fitness costs of refusing aid to a juvenile who is a possible offspring.

  1. Baboons, water, and the ecology of oxygen stable isotopes in an arid hybrid zone.

    Science.gov (United States)

    Moritz, Gillian L; Fourie, Nicolaas; Yeakel, Justin D; Phillips-Conroy, Jane E; Jolly, Clifford J; Koch, Paul L; Dominy, Nathaniel J

    2012-01-01

    Baboons regularly drink surface waters derived from atmospheric precipitation, or meteoric water. As a result, the oxygen isotope (δ(18)O) composition of their tissues is expected to reflect that of local meteoric waters. Animal proxies of the oxygen isotope composition of meteoric water have practical applications as paleoenvironmental recorders because they can be used to infer aridity and temperature in historic and fossil systems. To explore this premise, we measured the δ(18)O values of hair from two baboon species, Papio anubis and Papio hamadryas, inhabiting Awash National Park, Ethiopia. The hybridizing taxa differ in their ranging behavior and physiological response to heat. Papio hamadryas ranges more widely in the arid thornbush and is inferred to ingest a greater proportion of leaf water that is enriched in (18)O as a result of evaporative fractionation. It is also better able to conserve body water, which reduces its dependence on meteoric waters depleted in (18)O. Taken together, these factors would predict relatively higher δ(18)O values in the hair (δ(18)O(hair)) of P. hamadryas. We found that the δ(18)O(hair) values of P. hamadryas were higher than those of P. anubis, yet the magnitude of the difference was marginal. We attribute this result to a common source of drinking water, the Awash River, and the longer drinking bouts of P. hamadryas. Our findings suggest that differences in δ(18)O values among populations of Papio (modern or ancient) reflect different sources of drinking water (which might have ecological significance) and, further, that Papio has practical value as a paleoenvironmental recorder.

  2. Endothelial reconstitution by CD34+ progenitors derived from baboon embryonic stem cells.

    Science.gov (United States)

    Shi, Qiang; Schatten, Gerald; Hodara, Vida; Simerly, Calvin; VandeBerg, John L

    2013-02-01

    In this study, we used a large non-human primate model, the baboon, to establish a step-wise protocol to generate CD34+ endothelial progenitor cells (EPCs) from embryonic stem cells (ESCs) and to demonstrate their reparative effects. Baboon ESCs were sequentially differentiated from embryoid body cultures for 9 days and then were specified into EPCs by culturing them in monolayer for 12 days. The resulting EPCs expressed CD34, CXCR4 and UEA-1, but neither CD31 nor CD117. The EPCs were able to form intact lumen structures when seeded on Matrigel, took up Dil-LDL, and responded to TNF-α. Angioblasts specified in EGM-2 medium and ECGS medium had 6.41 ± 1.16% (n = 3) and 9.32 ± 3.73% CD34+ cells (n = 3). The efficiency of generating CD34+ EPCs did not differ significantly from ECGS to EGM-2 culture media, however, angioblasts specified in ECGS medium expressed a higher percentage of CD34+/CXCR4+ cells (3.49 ± 1.32%, n = 3) than those specified in EGM-2 medium (0.49 ± 0.52%, n = 3). To observe their reparative capacity, we purified CD34+ progenitors after specification by EGM-2 medium; inoculated fluorescently labelled CD34+ EPCs into an arterial segment denuded of endothelium in an ex vivo system. After 14 days of ex vivo culture, the grafted cells had attached and integrated to the denuded surface; in addition, they had matured further and expressed terminally differentiated endothelial markers including CD31 and CD146. In conclusion, we have proved that specified CD34+ EPCs are promising therapeutic agents for repairing damaged vasculature.

  3. Pulp response to ferric sulfate, diluted formocresol and IRM in pulpotomized primary baboon teeth.

    Science.gov (United States)

    Fuks, A B; Eidelman, E; Cleaton-Jones, P; Michaeli, Y

    1997-01-01

    This study investigated the pulp response to a 15.5 percent ferric sulfate solution (FS) and a 20 percent dilution of formocresol (DFC) in pulpotomized primary teeth of baboons, after four and eight weeks. Pulpotomies were performed in seventy-nine primary teeth of 4 baboons. After coronal pulp resection, the pulp stumps were painted with ferric sulfate for fifteen seconds, in thirty-two teeth (group 1); in another thirty-two teeth, a cotton pellet moistened with dilution of formocresol was placed over the pulp stumps for five minutes, and removed (group 2). In fifteen teeth, IRM was placed directly over the pulp stumps after hemostasis (group 3--control). The teeth of all groups were sealed with IRM, and examined for inflammatory changes under a microscope by two blinded examiners. Seventy-seven teeth were assessed. Mild or no inflammation was found in 58 percent (18/31) of the teeth of group 1, in 48 percent (15/31) of those of group 2, and in 73 percent (11/15) of those of group 3. Severe inflammation was found in 35 percent (11/31) of group 1, 29 percent (9/31) of group 2, and in 7 percent (1/15) of group 3. No statistically significant difference between the three groups was observed for degree of inflammation, periradicular or interradicular abscess or inflammatory root resorption (chi-square p > 0.05). Dentin bridges were observed in 52 percent (16/31) of the teeth in group 1, 52 percent (16/31) of those of group 2, and in 73 percent (11/15) of those of group 3. No difference was found between the experimental and control groups for the presence of dentin bridge, (p > 0.05). Ferric sulfate produced pulp responses that compared favorably to those of diluted formocresol.

  4. Erythropoietic protoporphyria and pretransplantation treatment with nonbiological liver assist devices

    DEFF Research Database (Denmark)

    Eefsen, Martin; Rasmussen, Allan; Wulf, Hans Christian

    2007-01-01

    of patients liver failure is a significant complication and liver transplantation is the only treatment option. Damage to both abdominal skin and organs occurs when exposed to operating light; however, this problem can be ameliorated by the use of filters that block the transmission of light with wavelength...... below 470 nm. A more unusual but very serious complication postoperatively is severe motor neuropathy, with few or no known acute available precautions. An effective treatment option is needed to manage EPP crises and to prevent complications after liver transplantation. We successfully treated...... made a reduction in RBC-PPIX concentration of 0.8%. Following treatment sessions with MARS and Prometheus, the clinical condition was markedly improved and orthotopic liver transplantation was performed without further complications. In conclusion, extracorporeal therapy with MARS or Prometheus seems...

  5. A 15-year-old girl with severe hemolytic Wilson's crisis recovered without transplantation after extracorporeal circulation with the Prometheus system.

    Science.gov (United States)

    Aagaard, Niels Kristian; Thomsen, Karen Louise; Holland-Fischer, Peter; Jørgensen, Søren Peter; Ott, Peter

    2009-01-01

    Wilson's disease (WD) can present in a fulminant form with hepatocellular dysfunction, hemolysis and multiorgan failure (Wilson's crisis). We present a previously healthy young woman with severe WD whose WD severity score was 13. A score >11 indicates a poor chance of survival and liver transplantation will usually be recommended. Penicillamine and acetylcysteine were initially administered, but the patient deteriorated further, and extracorporeal liver support with the Prometheus FPSA (fractionated plasma separation and adsorption) system was initiated. The patient was treated 6 h daily during 3 consecutive days. Severe hemolysis was reduced to low-grade hemolysis, with no further need for transfusions. The mental state improved and after 4 months practically all biochemical markers were normalized. This is the first report of FPSA albumin dialysis of a patient with Wilson's crisis and the first report in which a patient with a WD score >11 survived without transplantation.

  6. Radial extracorporeal shock wave therapy for heterotopic ossification

    OpenAIRE

    Ryu, Byung-Ju; Ha, Kang-Wook; Lee, Jin-Young; Kim, Sung-Hwan; Kwak, Ho-Jun; Seol, Pyong-Hwa

    2016-01-01

    [Purpose] To report the effects of radial extracorporeal shock wave therapy (RSWT) on heterotopic ossification (HO). [Subjects and Methods] Two cases of neurogenic HO in the upper extremity were administered RSWT using the MASTER PLUS® MP 2000 (Storz, Tägerwilen, Switzerland) and ultrasonographic guidance. The RSWT protocol consisted of 3,000 pulses at a frequency of 12 Hz during each treatment. The intensity level ranged from 2–5 bars, and it was administered 5 times a week for 4 weeks, a to...

  7. Technological advances in extracorporeal membrane oxygenation for respiratory failure.

    Science.gov (United States)

    Rehder, Kyle J; Turner, David A; Bonadonna, Desiree; Walczak, Richard J; Rudder, Robert J; Cheifetz, Ira M

    2012-08-01

    Extracorporeal membrane oxygenation (ECMO) for neonatal and pediatric cardiac and/or respiratory failure is well established, and its use for adult respiratory failure is rapidly increasing. Management strategies developed over the past 30 years coupled with significant recent technological advances have led to improved ECMO survival. These new technologies are expanding the potential applications for ECMO in exciting ways, including new patient populations and the ability to make ECMO mobile for both intra- and inter-hospital transport. In this article, we highlight some of the recent technological advances and their impact on the utilization of ECMO in increasingly diverse patient populations.

  8. Extracorporeal membrane oxygenation after intravenous injection of paraffin oil

    DEFF Research Database (Denmark)

    Pasgaard, Thomas; Huynh, Anh-Nhi Thi; Gjedsted, Jakob

    2016-01-01

    We present a rare cause of acute respiratory distress syndrome (ARDS) due to an accidental intravascular injection of paraffin oil. While there is no specific therapy, we decided to support the patient with veno-venous extracorporeal membrane oxygenation (V-V ECMO) to allow the ARDS to resolve....... A previously healthy 30-year-old man was admitted to the Emergency Department with acute onset respiratory distress following an injection with paraffin oil for cosmetic purposes. In 36 hours, the patient developed severe ARDS and respiratory support with V-V ECMO was initiated. The patient was successfully...

  9. CT appearance of renal hemorrhage after extracorporeal shock wave lithotripsy

    Energy Technology Data Exchange (ETDEWEB)

    Kanazawa, Susumu; Araki, Toru; Takamoto, Hitoshi; Hata, Kazuhiro

    1988-07-01

    Computed Tomography (CT) was performed in three patients who were suspicious of renal hemorrhage after extracorporeal shock wave lithotripsy (ESWL). Post-ESWL scans demonstrated subcapsular hematoma in all three cases, and intrarenal hemorrhage in two cases, one of which had fluid collection in the pararenal space and hemorrhage in the posterior pararenal space on CT. Thickening of gerota fascia and bridging septa in the perirenal space was visualized on CT in all of them. CT demonstrated clearly the anatomic distribution and extent of renal hemorrhage, and it is important to comprehend the imaging anatomy of the perirenal area for CT evaluation.

  10. Diffuse coronary artery spasm treated by extracorporeal membrane oxygenation.

    Science.gov (United States)

    Smith, Chez; Akowuah, Enoch; Theodore, Sanjay; Brown, Robin

    2009-07-01

    Diffuse coronary vasospasm is an unpredictable and serious complication following coronary artery bypass surgery. The treatment of this emergency is dependent on patient suitability for angiography and direct injection of vasodilators into the affected vessels. In patients unable to proceed to angiography the diagnosis can only be suspected but treatment is nevertheless still towards reinstitution of coronary blood flow. We present one such case in which re-grafting and extracorporeal membranous oxygenation proved successful in restoring cardiac function in a patient with diffuse coronary artery spasm.

  11. Vascular access for extracorporeal renal replacement therapy in veterinary patients.

    Science.gov (United States)

    Chalhoub, Serge; Langston, Cathy E; Poeppel, Karen

    2011-01-01

    Vascular access is the first and most basic requirement for successful extracorporeal renal replacement therapy (ERRT). Dual-lumen catheters are the most commonly used method of vascular access for ERRT in veterinary patients. An adequately functioning dialysis catheter allows for smooth and efficient patient management, whereas a poorly functioning catheter frustrates the technician, doctor, and patient. These catheters are fairly quick to place but require meticulous care for optimal function. The most common complications are thrombosis and infection. Monitoring catheter performance should be a routine part of dialysis patient care.

  12. Extracorporeal Free Flap Perfusion in Case of Prolonged Ischemia Time

    OpenAIRE

    Taeger, C. D.; Präbst, K; Beier, J P; Meyer, A; Horch, R E

    2016-01-01

    Summary: In free flap surgery, a clinically established concept still has to be found for the reduction of ischemia-related cell damage in the case of prolonged ischemia. Although promising results using extracorporeal free flap perfusion in the laboratory have been published in the past, until now this concept has not yet paved its way into clinical routine. This might be due to the complexity of perfusion systems and a lack of standardized tools. Here, we want to present the results of the ...

  13. Liver Immunology

    Science.gov (United States)

    Bogdanos, Dimitrios P.; Gao, Bin; Gershwin, M. Eric

    2014-01-01

    The liver is the largest organ in the body and is generally regarded by non-immunologists as not having lymphoid function. However, such is far from accurate. This review highlights the importance of the liver as a lymphoid organ. Firstly, we discuss experimental data surrounding the role of liver as a lymphoid organ. The liver facilitates a tolerance rather than immunoreactivity, which protects the host from antigenic overload of dietary components and drugs derived from the gut and is also instrumental to fetal immune tolerance. Loss of liver tolerance leads to autoaggressive phenomena which if are not controlled by regulatory lymphoid populations may lead to the induction of autoimmune liver diseases. Liver-related lymphoid subpopulations also act as critical antigen-presenting cells. The study of the immunological properties of liver and delineation of the microenvironment of the intrahepatic milieu in normal and diseased livers provides a platform to understand the hierarchy of a series of detrimental events which lead to immune-mediated destruction of the liver and the rejection of liver allografts. The majority of emphasis within this review will be on the normal mononuclear cell composition of the liver. However, within this context, we will discus select, but not all, immune mediated liver disease and attempt to place these data in the context of human autoimmunity. PMID:23720323

  14. Derivation and characterization of novel nonhuman primate embryonic stem cell lines from in vitro-fertilized baboon preimplantation embryos.

    Science.gov (United States)

    Chang, Tien-Cheng; Liu, Ya-Guang; Eddy, Carlton A; Jacoby, Ethan S; Binkley, Peter A; Brzyski, Robert G; Schenken, Robert S

    2011-06-01

    The development of nonhuman primate (NHP) embryonic stem cell (ESC) models holds great promise for cell-mediated treatment of debilitating diseases and to address numerous unanswered questions regarding the therapeutic efficacy of ESCs while supplanting ethical considerations involved with human studies. Here we report successful establishment and characterization of 3 novel baboon (Papio cynocephalus) ESC lines from the inner cell mass of intracytoplasmic sperm injection-derived blastocysts. Embryos were cultured in an improved baboon embryo in vitro culture protocol. The inner cell mass of blastocyst was laser-dissected and plated on mouse embryonic fibroblast feeder cell monolayer in the NHP ESC culture medium. Three cell lines with characteristic ESC morphology have been cultured through an extended period (>14 months), with 2 male cell lines (UT-1 and -2) and 1 female cell line (UT-3) displaying normal baboon karyotypes. Reverse transcription-polymerase chain reaction analysis confirmed that all 3 lines express primate ESC pluripotency markers, including OCT-4, NANOG, SOX-2, TERT, TDGF, LEFTYA, and REX-1. All 3 lines demonstrated positive immunocytochemical staining for OCT-4, stage-specific embryonic antigen-3, stage-specific embryonic antigen-4, TRA-1-60, and TRA-1-81. Baboon ESCs injected into NOD/SCID mice formed teratomas with all 3 germ layers. In addition, embryoid body-like spherical structures were derived and initial outgrowth was observed when embedded into extracellular matrix Matrigel. The ESC lines established in this NHP model have the potential to extend our knowledge in the fields of developmental biology, regenerative medicine, and future applications, including preclinical safety assessment of in vivo stem cell therapy.

  15. A failure mode effect analysis on extracorporeal circuits for cardiopulmonary bypass.

    Science.gov (United States)

    Wehrli-Veit, Michel; Riley, Jeffrey B; Austin, Jon W

    2004-12-01

    Although many refinements in perfusion methodology and devices have been made, extracorporeal circulation remains a contributor to neurological complications, bleeding coagulopathies, use of blood products, as well as systemic inflammatory response. With the exposure of these adverse effects of cardiopulmonary bypass, the necessity to re-examine the safety of extracorporeal circuits is vital. A failure mode effect analysis (FMEA) is a proven proactive technique developed to evaluate system effect or equipment failure. FMEA was used to evaluate the six different types of extracorporeal circuits based on feedback from five clinical experts. Cardiovascular device manufacturers, the Veteran's Administration National Center for Patient Safety, and the Joint Commission on Accreditation of Healthcare Organizations recommend the use of FMEA to assess and manage risks in current and developing technologies and therapies. This analysis investigates the safety of six types of extracorporeal circuits used in coronary revascularization, including the newer miniaturized extracorporeal circuits. The FMEA lists and ranks the hazards associated with the use of each cardiopulmonary bypass extracorporeal circuit type. To increase the safety of extracorporeal circuits and minimize the effects associated with cardiopulmonary bypass, perfusionists must incorporate FMEA into their clinical practice.

  16. Predictive models of insulin resistance derived from simple morphometric and biochemical indices related to obesity and the metabolic syndrome in baboons

    Science.gov (United States)

    Chavez, Alberto O; Gastaldelli, Amalia; Guardado-Mendoza, Rodolfo; Lopez-Alvarenga, Juan C; Leland, M Michelle; Tejero, M Elizabeth; Sorice, GianPio; Casiraghi, Francesca; Davalli, Alberto; Bastarrachea, Raúl A; Comuzzie, Anthony G; DeFronzo, Ralph A; Folli, Franco

    2009-01-01

    Background Non-human primates are valuable models for the study of insulin resistance and human obesity. In baboons, insulin sensitivity levels can be evaluated directly with the euglycemic clamp and is highly predicted by adiposity, metabolic markers of obesity and impaired glucose metabolism (i.e. percent body fat by DXA and HbA1c). However, a simple method to screen and identify obese insulin resistant baboons for inclusion in interventional studies is not available. Methods We studied a population of twenty baboons with the euglycemic clamp technique to characterize a population of obese nondiabetic, insulin resistant baboons, and used a multivariate linear regression analysis (adjusted for gender) to test different predictive models of insulin sensitivity (insulin-stimulated glucose uptake = Rd) using abdominal circumference and fasting plasma insulin. Alternatively, we tested in a separate baboon population (n = 159), a simpler model based on body weight and fasting plasma glucose to predict the whole-body insulin sensitivity (Rd/SSPI) derived from the clamp. Results In the first model, abdominal circumference explained 59% of total insulin mediated glucose uptake (Rd). A second model, which included fasting plasma insulin (log transformed) and abdominal circumference, explained 64% of Rd. Finally, the model using body weight and fasting plasma glucose explained 51% of Rd/SSPI. Interestingly, we found that percent body fat was directly correlated with the adipocyte insulin resistance index (r = 0.755, p < 0.0001). Conclusion In baboons, simple morphometric measurements of adiposity/obesity, (i.e. abdominal circumference), plus baseline markers of glucose/lipid metabolism, (i.e. fasting plasma glucose and insulin) provide a feasible method to screen and identify overweight/obese insulin resistant baboons for inclusion in interventional studies aimed to study human obesity, insulin resistance and type 2 diabetes mellitus. PMID:19389241

  17. Predictive models of insulin resistance derived from simple morphometric and biochemical indices related to obesity and the metabolic syndrome in baboons

    Directory of Open Access Journals (Sweden)

    Bastarrachea Raúl A

    2009-04-01

    Full Text Available Abstract Background Non-human primates are valuable models for the study of insulin resistance and human obesity. In baboons, insulin sensitivity levels can be evaluated directly with the euglycemic clamp and is highly predicted by adiposity, metabolic markers of obesity and impaired glucose metabolism (i.e. percent body fat by DXA and HbA1c. However, a simple method to screen and identify obese insulin resistant baboons for inclusion in interventional studies is not available. Methods We studied a population of twenty baboons with the euglycemic clamp technique to characterize a population of obese nondiabetic, insulin resistant baboons, and used a multivariate linear regression analysis (adjusted for gender to test different predictive models of insulin sensitivity (insulin-stimulated glucose uptake = Rd using abdominal circumference and fasting plasma insulin. Alternatively, we tested in a separate baboon population (n = 159, a simpler model based on body weight and fasting plasma glucose to predict the whole-body insulin sensitivity (Rd/SSPI derived from the clamp. Results In the first model, abdominal circumference explained 59% of total insulin mediated glucose uptake (Rd. A second model, which included fasting plasma insulin (log transformed and abdominal circumference, explained 64% of Rd. Finally, the model using body weight and fasting plasma glucose explained 51% of Rd/SSPI. Interestingly, we found that percent body fat was directly correlated with the adipocyte insulin resistance index (r = 0.755, p Conclusion In baboons, simple morphometric measurements of adiposity/obesity, (i.e. abdominal circumference, plus baseline markers of glucose/lipid metabolism, (i.e. fasting plasma glucose and insulin provide a feasible method to screen and identify overweight/obese insulin resistant baboons for inclusion in interventional studies aimed to study human obesity, insulin resistance and type 2 diabetes mellitus.

  18. Liver Diseases

    Science.gov (United States)

    Your liver is the largest organ inside your body. It helps your body digest food, store energy, and remove poisons. There are many kinds of liver diseases: Diseases caused by viruses, such as hepatitis ...

  19. Fatty Liver

    Science.gov (United States)

    ... Abbreviations Weights & Measures ENGLISH View Professional English Deutsch Japanese Espaniol Find information on medical topics, symptoms, drugs, ... inside liver cells. Just consuming a high-fat diet does not result in fatty liver. Rarely, fat ...

  20. Liver disease

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/000205.htm Liver disease To use the sharing features on this page, please enable JavaScript. The term "liver disease" applies to many conditions that stop the ...

  1. Liver Disease

    Science.gov (United States)

    ... stay still. Liver disease has many causes. Infection Parasites and viruses can infect the liver, causing inflammation ... beyond. National Institute of Diabetes and Digestive and Kidney Diseases. http://digestive.niddk.nih.gov/ddiseases/pubs/ ...

  2. Immunisation of baboons against Schistosoma mansoni using irradiated S. mansoni cercariae and schistosomula and non-irradiated S. rodhaini cercariae.

    Science.gov (United States)

    Taylor, M G; James, E R; Nelson, G S; Bickle, Q; Andrews, B J; Dobinson, A R; Webbe, G

    1976-09-01

    In an attempt to develop a non-pathogenic procedure for immunising baboons against S. mansoni, groups of five baboons were exposed to three doses of 5000 6 Kr-irradiated S. mansoni cercariae or to similar numbers of normal S. rodhaini cercariae and challenged at week 15 with 500 normal S. mansoni cercariae. Faecal egg counts, worm and tissue egg counts, and histopathological examination, showed that neither of the immunising schedules had produced significant protection. In the second experiment baboons were injected by the intramuscular route with 31000 schistosomula of S. mansoni in three doses and the irradiation dose was reduced to near the minimum required for worm sterilisation (2-1--2-4 Kr). Challenge with 3500 normal cercariae of S. mansoni 21 weeks after the first immunising dose again showed no significant protection, although reductions of 20--30% were found in egg and worm counts resulting from the challenge. These results indicate that it may be difficult to develop an effective live vaccine for S. mansoni unless the antigenicity of the immunising larvae can be greatly increased.

  3. Neonatal and pediatric extracorporeal membrane oxygenation in developing Latin American countries.

    Science.gov (United States)

    Kattan, Javier; González, Álvaro; Castillo, Andrés; Caneo, Luiz Fernando

    To review the principles of neonatal-pediatric extracorporeal membrane oxygenation therapy, prognosis, and its establishment in limited resource-limited countries in Latino America. The PubMed database was explored from 1985 up to the present, selecting from highly-indexed and leading Latin American journals, and Extracorporeal Life Support Organization reports. Extracorporeal membrane oxygenation provides "time" for pulmonary and cardiac rest and for recovery. It is used in the neonatal-pediatric field as a rescue therapy for more than 1300 patients with respiratory failure and around 1000 patients with cardiac diseases per year. The best results in short- and long-term survival are among patients with isolated respiratory diseases, currently established as a standard therapy in referral centers for high-risk patients. The first neonatal/pediatric extracorporeal membrane oxygenation Program in Latin America was established in Chile in 2003, which was also the first program in Latin America to affiliate with the Extracorporeal Life Support Organization. New extracorporeal membrane oxygenation programs have been developed in recent years in referral centers in Argentina, Colombia, Brazil, Mexico, Perú, Costa Rica, and Chile, which are currently funding the Latin American Extracorporeal Life Support Organization chapter. The best results in short- and long-term survival are in patients with isolated respiratory diseases. Today extracorporeal membrane oxygenation therapy is a standard therapy in some Latin American referral centers. It is hoped that these new extracorporeal membrane oxygenation centers will have a positive impact on the survival of newborns and children with respiratory or cardiac failure, and that they will be available for an increasing number of patients from this region in the near future. Copyright © 2016 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  4. [A method of extracorporeal perfusion of the sections of xenogeneic spleen].

    Science.gov (United States)

    Borisov, A E; Zhidkov, K P; Dmitriev, N V; Domanskaia, I A

    1989-07-01

    A method of extracorporeal perfusion of sections of the swine spleen developed by the authors is described. Perfusion of the swine spleen sections was performed in the small volume perfusion chamber (100 cm3) with a 80-100 ml/min rate for 30-60 min with the help of a roller pump. The extracorporeal contour was connected with the major veins of the patient. An experience with the treatment of 23 patients with pyo-septic diseases with the use of extracorporeal perfusion of the swine spleen sections shows the efficiency, simplicity and safety of the proposed method.

  5. Ultrasonic Doppler blood flow meter for extracorporeal circulation

    Science.gov (United States)

    Dantas, Ricardo G.; Costa, Eduardo T.; Maia, Joaquim M.; Nantes Button, Vera L. d. S.

    2000-04-01

    In cardiac surgeries it is frequently necessary to carry out interventions in internal heart structures, and where the blood circulation and oxygenation are made by artificial ways, out of the patient's body, in a procedure known as extracorporeal circulation (EC). During this procedure, one of the most important parameters, and that demands constant monitoring, is the blood flow. In this work, an ultrasonic pulsed Doppler blood flowmeter, to be used in an extracorporeal circulation system, was developed. It was used a 2 MHz ultrasonic transducer, measuring flows from 0 to 5 liters/min, coupled externally to the EC arterial line destined to adults perfusion (diameter of 9.53 mm). The experimental results using the developed flowmeter indicated a maximum deviation of 3.5% of full scale, while the blood flow estimator based in the rotation speed of the peristaltic pump presented deviations greater than 20% of full scale. This ultrasonic flowmeter supplies the results in a continuous and trustworthy way, and it does not present the limitations found in those flowmeters based in other transduction methods. Moreover, due to the fact of not being in contact with the blood, it is not disposable and it does not need sterilization, reducing operational costs and facilitating its use.

  6. Extracorporeal shock wave therapy does not improve hypertensive nephropathy.

    Science.gov (United States)

    Caron, Jonathan; Michel, Pierre-Antoine; Dussaule, Jean-Claude; Chatziantoniou, Christos; Ronco, Pierre; Boffa, Jean-Jacques

    2016-06-01

    Low-energy extracorporeal shock wave therapy (SWT) has been shown to improve myocardial dysfunction, hind limb ischemia, erectile function, and to facilitate cell therapy and healing process. These therapeutic effects were mainly due to promoting angiogenesis. Since chronic kidney diseases are characterized by renal fibrosis and capillaries rarefaction, they may benefit from a proangiogenic treatment. The objective of our study was to determine whether SWT could ameliorate renal repair and favor angiogenesis in L-NAME-induced hypertensive nephropathy in rats. SWT was started when proteinuria exceeded 1 g/mmol of creatinine and 1 week after L-NAME removal. SWT consisted of implying 0.09 mJ/mm(2) (400 shots), 3 times per week. After 4 weeks of SWT, blood pressure, renal function and urinary protein excretion did not differ between treated (LN + SWT) and untreated rats (LN). Histological lesions including glomerulosclerosis and arteriolosclerosis scores, tubular dilatation and interstitial fibrosis were similar in both groups. In addition, peritubular capillaries and eNOS, VEGF, VEGF-R, SDF-1 gene expressions did not increase in SWT-treated compared to untreated animals. No procedural complications or adverse effects were observed in control (C + SWT) and hypertensive rats (LN + SWT). These results suggest that extracorporeal kidney shock wave therapy does not induce angiogenesis and does not improve renal function and structure, at least in the model of hypertensive nephropathy although the treatment is well tolerated.

  7. Extracorporeal shock waves as curative therapy for varicose veins?

    Directory of Open Access Journals (Sweden)

    Fiorenzo Angehrn

    2008-03-01

    Full Text Available Fiorenzo Angehrn1, Christoph Kuhn1, Ortrud Sonnabend2, Axel Voss31Klinik Piano, Biel, Switzerland; 2Pathodiagnostics, Herisau, Switzerland; 3SwiTech Medical AG, Kreuzlingen, SwitzerlandAbstract: In this prospective design study the effects of low-energy partially focused extracorporeal generated shock waves (ESW onto a subcutaneous located varicose vein – left vena saphena magna (VSM – are investigated. The treatment consisted of 4 ESW applications within 21 days. The varicose VSM of both sides were removed by surgery, and samples analyzed comparing the treated and untreated by means of histopathology. No damage to the treated varicose vein in particular and no mechanical destruction to the varicose vein’s wall could be demonstrated. However, an induction of neo-collagenogenesis was observed. The thickness of the varicose vein’s wall increased. Optimization of critical application parameters by investigating a larger number of patients may turn ESW into a non-invasive curative varicose treatment.Keywords: curative therapy, extra-cellular matrix (ECM, histopathologic changes of varicose veins, extracorporeal shock wave (ESW, progenitor cells

  8. Pulmonary decontamination for photodynamic inactivation with extracorporeal illumination

    Science.gov (United States)

    Geralde, Mariana C.; Leite, Ilaiáli S.; Inada, Natalia M.; Grecco, Clóvis; Medeiros, Alexandra I.; Kurachi, Cristina; Bagnato, Vanderlei S.

    2014-03-01

    Infectious pneumonia is a major cause of morbidity and mortality, despite advances in diagnostics and therapeutics in pulmonary infections. One of the major difficulties associated with the infection comes from the high rate of antibiotic resistant microorganisms, claiming for the use of alternative techniques with high efficiency and low cost. The photodynamic inactivation (PDI) is emerging as one of the great possibilities in this area, once its action is oxidative, not allowing microorganism develops resistance against the treatment. PDI for decontamination pulmonary has potential for treatment or creating better conditions for the action of antibiotics. In this study, we are developing a device to implement PDI for the treatment of lung diseases with extracorporeal illumination. To validate our theory, we performed measurements in liquid phantom to simulate light penetration in biological tissues at various fluency rates, the temperature was monitored in a body of hairless mice and the measurements of light transmittance in this same animal model. A diode laser emitting at 810 nm in continuous mode was used. Our results show 70% of leakage at 0.5 mm of thickness in phantom model. The mouse body temperature variation was 5.4 °C and was observed light transmittance through its chest. These results are suggesting the possible application of the extracorporeal illumination using infrared light source. Based on these findings, further studies about photodynamic inactivation will be performed in animal model using indocyanine green and bacteriochlorin as photosensitizers. The pulmonary infection will be induced with Streptococcus pneumoniae and Klebsiella pneumoniae.

  9. Extracorporeal piezoelectric lithotripsy for complicated bile duct stones.

    Science.gov (United States)

    Weber, J; Adamek, H E; Riemann, J F

    1991-02-01

    Today, common bile duct stones are extracted endoscopically. After endoscopic sphincterotomy, nearly 90% of all stones can be removed with a Dormia basket or a mechanical lithotripter. Problems are encountered if there are larger stones or a duct stenosis. New conservative therapies do serve as an alternative to surgical intervention for those few patients in whom endoscopic measures have failed. Stone fragmentation can be achieved by extracorporeal shock wave lithotripsy, and remaining fragments can be removed endoscopically. So far, authors of most reports on the successful disintegration of common bile duct stones used the Dornier lithotripter. Stone localization is thus achieved with x-rays, and the shock waves are generated by an underwater spark discharge. We report on our experiences and results with extracorporeal piezoelectric shock wave lithotripsy (EPL) in 19 patients with complicated bile duct stones. With this lithotripter, stones are visualized by ultrasound, and shock waves are produced by a piezoelectric acoustic generator. Fragmentation was achieved in 84.2%, and complete stone removal in 78.9%. These results show that piezoelectric lithotripsy is also a useful method for the treatment of complicated bile duct stones, as has already been proved for the electrohydraulic- and electromagnetic-generated shock waves systems. However, the renunciation of general anesthesia and the need for analgesia or sedation in only 25% of the treatments render this lithotripter system attractive, especially for elderly and frail patients.

  10. Significant social events and increasing use of life-sustaining treatment: trend analysis using extracorporeal membrane oxygenation as an example.

    Science.gov (United States)

    Chen, Yen-Yuan; Chen, Likwang; Huang, Tien-Shang; Ko, Wen-Je; Chu, Tzong-Shinn; Ni, Yen-Hsuan; Chang, Shan-Chwen

    2014-03-04

    Most studies have examined the outcomes of patients supported by extracorporeal membrane oxygenation as a life-sustaining treatment. It is unclear whether significant social events are associated with the use of life-sustaining treatment. This study aimed to compare the trend of extracorporeal membrane oxygenation use in Taiwan with that in the world, and to examine the influence of significant social events on the trend of extracorporeal membrane oxygenation use in Taiwan. Taiwan's extracorporeal membrane oxygenation uses from 2000 to 2009 were collected from National Health Insurance Research Dataset. The number of the worldwide extracorporeal membrane oxygenation cases was mainly estimated using Extracorporeal Life Support Registry Report International Summary July 2012. The trend of Taiwan's crude annual incidence rate of extracorporeal membrane oxygenation use was compared with that of the rest of the world. Each trend of extracorporeal membrane oxygenation use was examined using joinpoint regression. The measurement was the crude annual incidence rate of extracorporeal membrane oxygenation use. Each of the Taiwan's crude annual incidence rates was much higher than the worldwide one in the same year. Both the trends of Taiwan's and worldwide crude annual incidence rates have significantly increased since 2000. Joinpoint regression selected the model of the Taiwan's trend with one joinpoint in 2006 as the best-fitted model, implying that the significant social events in 2006 were significantly associated with the trend change of extracorporeal membrane oxygenation use following 2006. In addition, significantly social events highlighted by the media are more likely to be associated with the increase of extracorporeal membrane oxygenation use than being fully covered by National Health Insurance. Significant social events, such as a well-known person's successful extracorporeal membrane oxygenation use highlighted by the mass media, are associated with the use of

  11. Influence of heat stress on arterial baroreflex control of heart rate in the baboon.

    Science.gov (United States)

    Gorman, A J; Proppe, D W

    1982-07-01

    The influence of environmental heat stress on the arterial baroreflex control of heart rate (HR) was studied in eight conscious, chronically instrumented baboons. Inflations of balloon occluders around the inferior vena cava (IVC) and thoracic descending aorta (DA) were used to produce acute, graded changes in mean arterial blood pressure (MABP) in 5 mm Hg intervals ranging from +/- 5 to +/- 25 mm Hg. After determination of the HR responses to changes in MABP in the normothermic baboon (blood temperature less than or equal to 37.6 degrees C), the animal was subjected to environmental heating to produce hyperthermia. When blood temperature reached approximately 39.5 degrees C, HR responses to graded DA and IVC occlusions were again determined. During hyperthermia, the HR sensitivity (delta HR/ delta MABP) to MABP changes was markedly diminished for reductions in MABP and significantly enhanced for increases in MABP. To determine whether these alterations in the HR response to changes in MABP were due to an alteration of the baroreflex control of HR, full, sigmoid-shaped HR-MABP curves for both the normothermic and hyperthermic states were constructed and characterized by total HR range, estimated slope of the steep portion of the curve, and MABP at the midpoint of the HR range (BP50). During hyperthermia (1) the whole HR-MABP curve shifted significantly upward by 35-40 beats/min, (2) total HR range, the estimated slope, and BP50 did not change, and (3) the control point (pre-occlusion HR-MABP value) curves were also constructed during either beta-adrenergic blockade or cholinergic (Ch)-receptor blockade in the normothermic and hyperthermic state. Similar to that seen for the unblocked heart, the whole HR-MABP curves were also shifted upward during hyperthermia in this group of baboons with no alteration in the total HR range, the estimated slope, or BP50. The upward shift in the HR-MABP curve during Ch-receptor blockade, unlike during beta-receptor blockade, was

  12. The organ preservation and enhancement of donation success ratio effect of extracorporeal membrane oxygenation in circulatory unstable brain death donor.

    Science.gov (United States)

    Fan, Xiaoli; Chen, Zhiquan; Nasralla, David; Zeng, Xianpeng; Yang, Jing; Ye, Shaojun; Zhang, Yi; Peng, Guizhu; Wang, Yanfeng; Ye, Qifa

    2016-10-01

    Between 2010 and 2013, we recorded 66 cases of failed organ donation after brain death (DBD) due to the excessive use of the vasoactive drugs resulting in impaired hepatic and/or renal function. To investigate the effect of extracorporeal membrane oxygenation (ECMO) in donor management, ECMO was used to provide support for DBD donors with circulatory and/or respiratory failure from 2013 to 2015. A retrospective cohort study between circulatory non-stable DBD with vasoactive drugs (DBD-drug) and circulatory non-stable DBD with ECMO (DBD-ECMO) was designed to compare the transplant outcomes. A total of 19 brain death donors were supported by ECMO. The incidence rate of post-transplant liver primary non-function (PNF) was 10% (two of 20) in DBD-drug group and zero in DBD-ECMO group. Kidney function indicators, including creatinine clearance and urine production, were significantly better in DBD-ECMO group, as well as the kidney delayed graft function (DGF) rate was found to be decreased by the use of ECMO in our study. Donation success rate increased steadily from 47.8% in 2011 to 84.6% in 2014 after the ECMO intervention. The use of ECMO in assisting circulatory and respiratory function of DBD can reduce liver and kidney injury from vasoactive drugs, thereby improving organ quality and reducing the organ discard rates.

  13. Effects of ozone on cyclooxygenase metabolites in the baboon tracheobronchial tree

    Energy Technology Data Exchange (ETDEWEB)

    Fouke, J.M.; DeLemos, R.A.; Dunn, M.J.; McFadden, E.R. Jr. (Southwest Foundation for Biomedical Research, San Antonio, TX (USA))

    1990-07-01

    Short-term exposure to 0.5 parts per million (ppm) ozone has been shown to cause an increase in respiratory resistance in primates that can be diminished by 50% with pretreatment with cromolyn sodium. Because of the known membrane-stabilizing effects of cromolyn and the resultant inhibition of mediator production, we hypothesized a role for the products of arachidonic acid (AA) metabolism in these events. We exposed five adult male baboons to 0.5 ppm ozone on two occasions, once with cromolyn pretreatment and once without. Pulmonary resistance (RL) was monitored and bronchoalveolar lavage (BAL) was performed before and after each exposure. The BAL was analyzed for a stable hydrolysis product of prostacyclin, 6-keto-prostaglandin (PG) F1 alpha, PGE2, a stable hydrolysis product of thromboxane (Tx) A2, TxB2, and PGF2 alpha. RL increased after ozone exposure (1.62 +/- 0.23 to 3.77 +/- 0.51 cmH2O.l-1.s, difference 2.15; P less than 0.02), and this effect was partially blocked by cromolyn (1.93 +/- 0.09 to 3.18 +/- 0.40 cmH2O.l-1.s, difference 1.25; P less than 0.02). The base-line levels of the metabolites of AA in the BAL were as follows (in pg/ml): 6-keto-PGF1 alpha 72.78 +/- 12.6, PGE2 145.92 +/- 30.52, TxB2 52.52 +/- 9.56, and PGF2 alpha 22.28 +/- 5.42. Ozone exposure had no effect on the level of any of these prostanoids (P = NS). These studies quantify the magnitude of cyclooxygenase products of AA metabolism in BAL from baboon lungs and demonstrate that changes in the levels of these mediators in BAL are not prerequisites for ozone-induced increases in respiratory resistance.

  14. Drug therapies in neonates and children during extracorporeal membrane oxygenation (ECMO) : Keep your eyes open

    NARCIS (Netherlands)

    E.D. Wildschut (Enno)

    2010-01-01

    markdownabstract__Abstract__ Extracorporeal life support (ECLS) or extra corporeal membrane oxygenation (ECMO) is a technique for providing life support in severe but potentially reversible cardiorespiratory failure in patients with an expected mortality greater than 80%. First pioneered in cardiop

  15. Current Applications for the Use of Extracorporeal Carbon Dioxide Removal in Critically Ill Patients

    National Research Council Canada - National Science Library

    Camporota, Luigi; Barrett, Nicholas

    2016-01-01

    .... Extracorporeal venovenous carbon dioxide removal (ECCO2R) appears to be a feasible means to facilitate more protective mechanical ventilation or potentially avoid mechanical ventilation in select patient groups...

  16. An extracorporeal carbon dioxide removal (ECCO2R) device operating at hemodialysis blood flow rates

    National Research Council Canada - National Science Library

    Jeffries, R Garrett; Lund, Laura; Frankowski, Brian; Federspiel, William J

    2017-01-01

    Extracorporeal carbon dioxide removal (ECCO2R) systems have gained clinical appeal as supplemental therapy in the treatment of acute and chronic respiratory injuries with low tidal volume or non-invasive ventilation...

  17. Intravascular volume administration: a contributing risk factor for intracranial hemorrhage during extracorporeal membrane oxygenation?

    NARCIS (Netherlands)

    Mol, A.C. de; Gerrits, L.C.; Heijst, A.F.J. van; Straatman, H.; Staak, F.H.J.M. van der; Liem, K.D.

    2008-01-01

    OBJECTIVE: The objective of this study was to determine the relationship between the frequency and total volume of intravascular volume administration and the development of intracranial hemorrhage during venoarterial extracorporeal membrane oxygenation. METHODS: In a retrospective, matched,

  18. Determinants of Pharmacokinetic Variability during Extracorporeal Membrane Oxygenation: A roadmap to rational pharmacotherapy in children

    NARCIS (Netherlands)

    M.J. Ahsman (Maurice)

    2010-01-01

    textabstractCritically-ill infants sometimes require extracorporeal membrane oxygenation (ECMO) to provide adequate oxygenation and perfusion. Pharmacokinetic data are often lacking for this particular population, which leads to dose regimens that are based on personal experience or extrapolation fr

  19. Regional thrombolysis with tenecteplase during extracorporeal membrane oxygenation: a new approach for left ventricular thrombosis.

    Science.gov (United States)

    Sangalli, Fabio; Greco, Gianluca; Galbiati, Lucia; Formica, Francesco; Calcinati, Serena; Avalli, Leonello

    2015-06-01

    We present the case of a woman assisted with veno-arterial extracorporeal membrane oxygenation (v-a ECMO) for postischemic cardiogenic shock, who developed left ventricular thrombosis despite systemic anticoagulation and left ventricular apical venting. We successfully achieved local thrombolysis with tenecteplase administered through the venting cannula to obtain local thrombolysis while reducing systemic effects to a minimum. The procedure was effective with mild systemic bleeding and the patient was successfully weaned off the extracorporeal support a few days thereafter.

  20. Lateral epicondylitis: This is still a main indication for extracorporeal shockwave therapy.

    Science.gov (United States)

    Thiele, S; Thiele, R; Gerdesmeyer, L

    2015-12-01

    Extracorporeal shockwave therapy (ESWT) is used in a number of indications in the medical field. A number of tendinopathies show good and excellent results due to evidence based medicine. The treatment of lateral epicondylitis is known to show conflicting results. This overview of the published RCT's on ESWT for lateral epicondylitis tries to show the reasons for this conflicting data-base and point out, why we think that this is still a main indication for extracorporeal shockwave therapy.

  1. High-energy focussed extracorporeal shockwave therapy reduces pain in plantar fibromatosis (Ledderhose’s disease)

    OpenAIRE

    Knobloch, Karsten; Peter M Vogt

    2012-01-01

    Background Plantar fibromatosis is a benign disease creating nodules on the medial plantar side of affected patients. While surgical removal is regarded as the therapeutic mainstay, recurrence rates and impairment of daily activities remains substantial. High-energy focussed extracorporeal shockwave therapy has been suggested to be potentially effective in plantar fibromatosis in terms of pain reduction. Hypothesis High-energy focussed extracorporeal shockwave therapy reduces pain in plantar ...

  2. Extracorporeal shock wave therapy for musculoskeletal pathology--a literature review.

    Science.gov (United States)

    Saw, A

    2005-07-01

    For more than two decades extracorporeal shock wave lithotripsy has emerged as the standard therapy for calculi in the kidney and urinary tract, and biliary system. Application of extracorporeal shock waves in orthopaedics involves treatment of recalcitrant chronic pain of plantar fasciitis, tennis elbow and calcifying tendonitis of the shoulder. This review explores current evidence-based issues related to its potential use as a treatment option for some musculoskeletal conditions.

  3. Can cellulite be treated with low-energy extracorporeal shock wave therapy?

    OpenAIRE

    Fiorenzo Angehrn; Christoph Kuhn; Axel Voss

    2008-01-01

    Fiorenzo Angehrn1, Christoph Kuhn1, Axel Voss21Klinik Piano, Gottstattstrasse 24, Biel, Switzerland; 2SwiTech Medical AG, Kreuzlingen, SwitzerlandAbstract: The present study investigates the effects of low-energy defocused extracorporeal generated shock waves on collagen structure of cellulite afflicted skin. Cellulite measurement using high-resolution ultrasound technology was performed before and after low-energy defocused extracorporeal shock wave therapy (ESWT) in 21 female subjects. ESWT...

  4. AN EXTRACORPOREAL STABILISED EXPANDED BED ADSORPTION METHOD FOR THE TREATMENT OF SEPSIS

    DEFF Research Database (Denmark)

    2004-01-01

    The present invention provides an extracorporeal adsorption method for removing harmful substances from blood in a way that is practicable in everyday clinical practice and applicable for the timely intervention to present the development of sepsis. Said extracorporeal adsorption method being...... effected by an adsorption column assembly where the adsorption column assembly comprising a column and an adsorption medium in the form of particles. The sedimented volume of said particles being at the most 80% of the volume of the column....

  5. Benign Liver Tumors

    Science.gov (United States)

    ... A Life After Diagnosis Support for Chronic Illness Corporate Partnerships Interview with Kristen Hanks Liver Lowdown July ... Disease , Liver Transplant , Liver Cancer , Liver Tumor , Liver Failure Help Fight Liver Disease We rely upon donations ...

  6. What Is Liver Cancer?

    Science.gov (United States)

    ... Research? Liver Cancer About Liver Cancer What Is Liver Cancer? Cancer starts when cells in the body ... structure and function of the liver. About the liver The liver is the largest internal organ. It ...

  7. Bypass during Liver Transplantation: Anachronism or Revival? Liver Transplantation Using a Combined Venovenous/Portal Venous Bypass—Experiences with 163 Liver Transplants in a Newly Established Liver Transplantation Program

    Directory of Open Access Journals (Sweden)

    Anne Mossdorf

    2015-01-01

    Full Text Available Introduction. The venovenous/portal venous (VVP bypass technique has generally become obsolete in liver transplantation (LT today. We evaluated our experience with 163 consecutive LTs that used a VVP bypass. Patients and Methods. The liver transplant program was started in our center in 2010. LTs were performed using an extracorporal bypass device. Results. Mean operative time was 269 minutes and warm ischemic time 43 minutes. The median number of transfusion of packed cells and plasma was 7 and 14. There was no intraoperative death, and the 30-day mortality was 3%. Severe bypass-induced complications did not occur. Discussion. The introduction of a new LT program requires maximum safety measures for all of the parties involved. Both surgical and anaesthesiological management (reperfusion can be controlled very reliably using a VVP bypass device. Particularly when using marginal grafts, this approach helps to minimise both surgical and anaesthesiological complications in terms of less volume overload, less use of vasopressive drugs, less myocardial injury, and better peripheral blood circulation. Conclusion. Based on our experiences while establishing a new liver transplantation program, we advocate the reappraisal of the extracorporeal VVP bypass.

  8. Bypass during Liver Transplantation: Anachronism or Revival? Liver Transplantation Using a Combined Venovenous/Portal Venous Bypass-Experiences with 163 Liver Transplants in a Newly Established Liver Transplantation Program.

    Science.gov (United States)

    Mossdorf, Anne; Ulmer, Florian; Junge, Karsten; Heidenhain, Christoph; Hein, Marc; Temizel, Ilknur; Neumann, Ulf Peter; Schöning, Wenzel; Schmeding, Maximilian

    2015-01-01

    Introduction. The venovenous/portal venous (VVP) bypass technique has generally become obsolete in liver transplantation (LT) today. We evaluated our experience with 163 consecutive LTs that used a VVP bypass. Patients and Methods. The liver transplant program was started in our center in 2010. LTs were performed using an extracorporal bypass device. Results. Mean operative time was 269 minutes and warm ischemic time 43 minutes. The median number of transfusion of packed cells and plasma was 7 and 14. There was no intraoperative death, and the 30-day mortality was 3%. Severe bypass-induced complications did not occur. Discussion. The introduction of a new LT program requires maximum safety measures for all of the parties involved. Both surgical and anaesthesiological management (reperfusion) can be controlled very reliably using a VVP bypass device. Particularly when using marginal grafts, this approach helps to minimise both surgical and anaesthesiological complications in terms of less volume overload, less use of vasopressive drugs, less myocardial injury, and better peripheral blood circulation. Conclusion. Based on our experiences while establishing a new liver transplantation program, we advocate the reappraisal of the extracorporeal VVP bypass.

  9. The effects of extracorporeal shock wave therapy on frozen shoulder patients' pain and functions.

    Science.gov (United States)

    Park, Chan; Lee, Sangyong; Yi, Chae-Woo; Lee, Kwansub

    2015-12-01

    [Purpose] The present study was conducted to examine the effects of extracorporeal shock wave therapy on frozen shoulder patients' pain and functions. [Subjects] In the present study, 30 frozen shoulder patients were divided into two groups: an extracorporeal shock wave therapy group of 15 patients and a conservative physical therapy group of 15 patients. [Methods] Two times per week for six weeks, the extracorporeal shock wave therapy group underwent extracorporeal shock wave therapy, and the conservative physical therapy group underwent general physical therapy. Visual analog scales were used to measure frozen shoulder patients' pain, and patient-specific functional scales were used to evaluate the degree of functional disorders. [Results] In intra-group comparisons, the two groups showed significant decreases in terms of visual analog scales and patient-specific functional scales, although the extracorporeal shock wave therapy group showed significantly lower scores than the conservative physical therapy group. [Conclusion] Extracorporeal shock wave therapy is considered an effective intervention for improving frozen shoulder patients' pain and functions.

  10. Experience and needs of family members of patients treated with extracorporeal membrane oxygenation.

    Science.gov (United States)

    Tramm, Ralph; Ilic, Dragan; Murphy, Kerry; Sheldrake, Jayne; Pellegrino, Vincent; Hodgson, Carol

    2017-06-01

    To explore the experiences of family members of patients treated with extracorporeal membrane oxygenation. Sudden onset of an unexpected and severe illness is associated with an increased stress experience of family members. Only one study to date has explored the experience of family members of patients who are at high risk of dying and treated with extracorporeal membrane oxygenation. A qualitative descriptive research design was used. A total of 10 family members of patients treated with extracorporeal membrane oxygenation were recruited through a convenient sampling approach. Data were collected using open-ended semi-structured interviews. A six-step process was applied to analyse the data thematically. Four criteria were employed to evaluate methodological rigour. Family members of extracorporeal membrane oxygenation patients experienced psychological distress and strain during and after admission. Five main themes (Going Downhill, Intensive Care Unit Stress and Stressors, Carousel of Roles, Today and Advice) were identified. These themes were explored from the four roles of the Carousel of Roles theme (decision-maker, carer, manager and recorder) that participants experienced. Nurses and other staff involved in the care of extracorporeal membrane oxygenation patients must pay attention to individual needs of the family and activate all available support systems to help them cope with stress and strain. An information and recommendation guide for families and staff caring for extracorporeal membrane oxygenation patients was developed and needs to be applied cautiously to the individual clinical setting. © 2016 John Wiley & Sons Ltd.

  11. Papio Cranium from the Hominin-Bearing Site of Malapa: Implications for the Evolution of Modern Baboon Cranial Morphology and South African Plio-Pleistocene Biochronology.

    Directory of Open Access Journals (Sweden)

    Christopher C Gilbert

    Full Text Available A new partial cranium (UW 88-886 of the Plio-Pleistocene baboon Papio angusticeps from Malapa is identified, described and discussed. UW 88-886 represents the only non-hominin primate yet recovered from Malapa and is important both in the context of baboon evolution as well as South African hominin site biochronology. The new specimen may represent the first appearance of modern baboon anatomy and coincides almost perfectly with molecular divergence date estimates for the origin of the modern P. hamadryas radiation. The fact that the Malapa specimen is dated between ~2.026-2.36 million years ago (Ma also has implications for the biochronology of other South African Plio-Pleistocene sites where P. angusticeps is found.

  12. A meta-analysis of complications and mortality of extracorporeal membrane oxygenation.

    Science.gov (United States)

    Zangrillo, Alberto; Landoni, Giovanni; Biondi-Zoccai, Giuseppe; Greco, Massimiliano; Greco, Teresa; Frati, Giacomo; Patroniti, Nicolò; Antonelli, Massimo; Pesenti, Antonio; Pappalardo, Federico

    2013-09-01

    To comprehensively assess published peer-reviewed studies related to extracorporeal membrane oxygenation (ECMO), focusing on outcomes and complications of ECMO in adult patients. Systematic review and meta-analysis. MEDLINE/PubMed was searched for articles on complications and mortality occurring during or after ECMO. Included studies had more than 100 patients receiving ECMO and reported in detail fatal or nonfatal complications occurring during or after ECMO. Primary outcome was mortality at the longest follow-up available; secondary outcomes were fatal and non-fatal complications. Twelve studies were included (1763 patients), mostly reporting on venoarterial ECMO. Criteria for applying ECMO were variable, but usually comprised acute respiratory failure, cardiogenic shock or both. After a median follow-up of 30 days (1st-3rd quartile, 30-68 days), overall mortality was 54% (95% CI, 47%-61%), with 45% (95% CI, 42%-48%) of fatal events occurring during ECMO and 13% (95% CI, 11%-15%) after it. The most common complications associated with ECMO were: renal failure requiring continuous venovenous haemofiltration (occurring in 52%), bacterial pneumonia (33%), any bleeding (33%), oxygenator dysfunction requiring replacement (29%), sepsis (26%), haemolysis (18%), liver dysfunction (16%), leg ischaemia (10%), venous thrombosis (10%), central nervous system complications (8%), gastrointestinal bleeding (7%), aspiration pneumonia (5%), and disseminated intravascular coagulation (5%). Even with conditions usually associated with a high chance of death, almost 50% of patients receiving ECMO survive up to discharge. Complications are frequent and most often comprise renal failure, pneumonia or sepsis, and bleeding.

  13. Effect of extracorporeal shock wave therapy on the shoulder joint functional status of patients with calcific tendinitis

    OpenAIRE

    2016-01-01

    [Purpose] This study aimed to analyze the effect of extracorporeal shock wave therapy on the shoulder function of patients with calcific tendinitis through a 12-week follow-up. [Subjects and Methods] A total of 34 patients with calcific tendinitis participated in this study. In the extracorporeal shock wave therapy group, 18 patients received 6-week extracorporeal shock wave therapy and 12-week follow-up. The Constant-Murley scale was used to evaluate shoulder joint function. [Results] Analys...

  14. Crowding increases salivary cortisol but not self-directed behavior in captive baboons.

    Science.gov (United States)

    Pearson, Brandon L; Reeder, DeeAnn M; Judge, Peter G

    2015-04-01

    Reduced space can lead to crowding in social animals. Crowding increases the risk of agonistic interactions that, in turn, may require additional physiological defensive coping mechanisms affecting health. To determine the stress induced from increased social density in a group of nineteen baboons living in an indoor/outdoor enclosure, saliva cortisol levels and rates of anxiety-related behavior were analyzed across two unique crowding episodes. Initially, mean salivary cortisol levels when animals were restricted to their indoor quarters were compared to those when they also had access to their larger outdoor enclosure. Then, mean cortisol levels were compared before, during, and after two distinct crowding periods of long and short duration. Crowding resulted in significantly elevated cortisol during crowding periods compared to non-crowded periods. Cortisol levels returned to baseline following two crowding episodes contrasting in their length and ambient climate conditions. These cortisol elevations indicate greater metabolic costs of maintaining homeostasis under social stress resulting from reduced space. Self-directed behavior, conversely, was not reliably elevated during crowding. Results suggest that the potential for negative social interactions, and/or the uncertainty associated with social threat can cause physiological stress responses detected by salivary cortisol. Self-directed behavioral measures of stress may constitute inadequate indicators of social stress in colony-housed monkeys or represent subjective emotional arousal unrelated to hypothalamic-pituitary adrenal axis activation.

  15. Behavioural processes in social context: female abductions, male herding and female grooming in hamadryas baboons.

    Science.gov (United States)

    Polo, Pablo; Colmenares, Fernando

    2012-06-01

    The formation of bonds between strangers is an event that occurs routinely in many social animals, including humans, and, as social bonds in general, they affect the individuals' welfare and biological fitness. The present study was motivated by an interest in the behavioural processes that drive bond formation in a social context of hostility, in which the incumbent partners vary greatly in physical power and reproductive interests, a situation in which individuals of many group-living species find themselves often throughout their lives. We focused on the quantitative analysis of female abductions via male aggressive herding in a nonhuman primate, the hamadryas baboon, in which intersexual bonds are known to be strong. We tested three hypotheses informed by sexual conflict/sexual coercion theory (male herding-as-conditioning and female grooming-as-appeasement) and by socioecological theory (unit size and female competition). The results supported the predictions: males resorted to coercive tactics (aggressive herding) with abducted females, and abducted females elevated the amount of grooming directed at their new unit males; in fact, they escaped from the otherwise negative effect of unit size on female-to-male grooming. These findings reveal that conflicts of interest are natural ingredients underpinning social bonds and that resorting to coercive aggression may be an option especially when partners differ greatly in their physical power.

  16. Ozone treatment of alveolar bone in the cape chacma baboon does not enhance healing following trauma.

    Science.gov (United States)

    Kotze, Marthinus; Bütow, Kürt-W; Olorunju, Steve A; Kotze, Harry F

    2014-06-01

    In the international literature, the role of Ozone (O3) in the advancement in alveolar bone healing in the absence of bone pathology was not tested before. The purpose of this study was to evaluate alveolar bone regeneration after a bone defect was created and treated with a single topical administration of O3. Alveolar bone defects were created on five healthy chacma baboons. One side of the maxilla and mandible was topically treated with a single treatment of an O3/O2 mixture (3,5-4 % O3), while the opposite sides were not treated and thus served as control. Regeneration was measured radiologically, using a standardized gray scale, as the increase in bone density in the treatment area at 3 and 6 weeks post-operative and was statistically analyzed using multivariate analysis of variance (MANOVA). There were no significant differences in densities observed between the O3/O2 mixture treatment and the control (p > 0.05). A single O3 treatment did not increase alveolar bone healing over a 3- and 6-week period in the mandible and the maxilla.

  17. Selective inhibition by a synthetic hirudin peptide of fibrin-dependent thrombosis in baboons

    Energy Technology Data Exchange (ETDEWEB)

    Cadroy, Y.; Hanson, S.R.; Harker, L.A. (Emory Univ., Atlanta, GA (United States)); Maraganore, J.M. (Biogen Inc., Cambridge, MA (United States))

    1991-02-15

    To determine the importance of the thrombin substrate recognition exosite for fibrinogen binding in the formation of both arterial and venous thrombi the authors evaluated the antithrombotic effects of the tyrosine-sulfated dodecapeptide from residues 53-64 of hirudin (H peptide) in a nonhuman primate model. This peptide was studied because it inhibits thrombin cleavages of fibrinogen by simple competition without blocking enzyme catalytic-site function. When an exteriorized arteriovenous access shunt model was used in baboons (Papio anubis), thrombus formation was induced by placing a thrombogenic device made of (i) a segment of tubing coated covalently with type I collagen, which generated platelet-rich thrombi under arterial flow conditions, and (ii) two subsequent annular regions of flow expansion that produced fibrin-rich thrombi typically associated with venous valves and veins. Thrombus formation was quantified by measurements of {sup 111}In-labeled platelet and {sup 125}I-labeled fibrinogen deposition in both arterial-flow and venous-flow portions of the device. These finding suggest that, by competitive inhibition of fibrinogen binding to thrombin, fibrin-rich venous-type thrombus formation may be selectively prevented. This strategy may be therapeutically attractive for preserving normal platelet function when conventional anticoagulant therapy is contraindicated.

  18. Social environment influences the relationship between genotype and gene expression in wild baboons.

    Science.gov (United States)

    Runcie, Daniel E; Wiedmann, Ralph T; Archie, Elizabeth A; Altmann, Jeanne; Wray, Gregory A; Alberts, Susan C; Tung, Jenny

    2013-05-19

    Variation in the social environment can have profound effects on survival and reproduction in wild social mammals. However, we know little about the degree to which these effects are influenced by genetic differences among individuals, and conversely, the degree to which social environmental variation mediates genetic reaction norms. To better understand these relationships, we investigated the potential for dominance rank, social connectedness and group size to modify the effects of genetic variation on gene expression in the wild baboons of the Amboseli basin. We found evidence for a number of gene-environment interactions (GEIs) associated with variation in the social environment, encompassing social environments experienced in adulthood as well as persistent effects of early life social environment. Social connectedness, maternal dominance rank and group size all interacted with genotype to influence gene expression in at least one sex, and either in early life or in adulthood. These results suggest that social and behavioural variation, akin to other factors such as age and sex, can impact the genotype-phenotype relationship. We conclude that GEIs mediated by the social environment are important in the evolution and maintenance of individual differences in wild social mammals, including individual differences in responses to social stressors.

  19. Mechanical ventilation in patients subjected to extracorporeal membrane oxygenation (ECMO).

    Science.gov (United States)

    Sánchez, M L

    2017-02-07

    Mechanical ventilation (MV) is a crucial element in the management of acute respiratory distress syndrome (ARDS), because there is high level evidence that a low tidal volume of 6ml/kg (protective ventilation) improves survival. In these patients with refractory respiratory insufficiency, venovenous extracorporeal membrane oxygenation (ECMO) can be used. This salvage technique improves oxygenation, promotes CO2 clearance, and facilitates protective and ultraprotective MV, potentially minimizing ventilation-induced lung injury. Although numerous trials have investigated different ventilation strategies in patients with ARDS, consensus is lacking on the optimal MV settings during venovenous ECMO. Although the concept of "lung rest" was introduced years ago, there are no evidence-based guidelines on its use in application to MV in patients supported by ECMO. How MV in ECMO patients can promote lung recovery and weaning from ventilation is not clear. The purpose of this review is to describe the ventilation strategies used during venovenous ECMO in clinical practice.

  20. Radial extracorporeal shock wave therapy for heterotopic ossification.

    Science.gov (United States)

    Ryu, Byung-Ju; Ha, Kang-Wook; Lee, Jin-Young; Kim, Sung-Hwan; Kwak, Ho-Jun; Seol, Pyong-Hwa

    2016-01-01

    [Purpose] To report the effects of radial extracorporeal shock wave therapy (RSWT) on heterotopic ossification (HO). [Subjects and Methods] Two cases of neurogenic HO in the upper extremity were administered RSWT using the MASTER PLUS(®) MP 2000 (Storz, Tägerwilen, Switzerland) and ultrasonographic guidance. The RSWT protocol consisted of 3,000 pulses at a frequency of 12 Hz during each treatment. The intensity level ranged from 2-5 bars, and it was administered 5 times a week for 4 weeks, a total of 20 treatments. [Results] RSWT improved pain, range of motion, and hand function in 2 patients with neurogenic HO in the upper extremity. [Conclusion] Further studies are needed to support these results and to understand the mechanism and to devise the protocol of RSWT for neurogenic HO.

  1. Patient information leaflets for extracorporeal shock wave lithotripsy: questionnaire survey

    Science.gov (United States)

    Askari, A; Shergill, I

    2012-01-01

    Objectives To compare the level of information provided in extracorporeal shock wave lithotripsy (ESWL) patient information leaflets in the London and East of England Deaneries Design All trusts in the London and East of England Deanery who offer an ESWL service were contacted and leaflets were compared Setting London and East of England Deanery Participants Alan Askari, Iqbal Shergill Main outcome measures Examination of key information that was communicated to ESWL patients via leaflets Results 12 trusts responded across the two deaneries. There was significant variation in the amount of information provided in the leaflets with some leaflets not containing an adequate level of instruction or information to patients Conclusions The authors propose that a national standardised information leaflet should be incorporated with the British Association of Urological Surgeons (BAUS) procedure specific information leaflet for ESWL procedures PMID:22666532

  2. Rehabilitation following intracerebral haemorrhage secondary to extracorporeal membrane oxygenation (ECMO).

    Science.gov (United States)

    Kilsby, Amanda; Buddha, Sandeep

    2013-05-24

    Extracorporeal membrane oxygenation (ECMO) was first used in adults with severe respiratory failure in the 1970s. Its use has been steadily increasing since the 1990s after a trial demonstrated improved survival. There are currently seven centres in the UK offering ECMO to adults. Neurological complications are often picked up within the first few days of initiating ECMO. Intracerebral haemorrhage is a well recognised complication and it is the leading cause of death in infants on ECMO and rates of 9-18.9% in adults have been reported. We report a 52-year-old woman admitted in severe type 1 respiratory failure in January 2012. She was transferred to a tertiary centre and suffered bitemporal and right parietal haemorrhages on ECMO in late February. She was repatriated to our unit for rehabilitation in April 2012. Her rehabilitation needs represent the complexity of this patient group with multiple medical, behavioural and physical challenges.

  3. [Severe pulmonary contusion after extracorporeal shock wave lithotripsy].

    Science.gov (United States)

    Samkaoui, M A; Ziadi, A; Harifi, G; El Adib, A Rhassan; Younous, S

    2009-03-01

    Extracorporeal shock wave lithotripsy (ESWL) is a simple and effective treatment of urinary stones. Renowned less aggressive than surgery, it knew a wide success and constitutes therefore the treatment of first intention of the majority of the kidney stones. Nevertheless, traumatic renal and extrarenal complications notably in lung can arise after ESWL. We report the case of a 28-year-old patient who had a pulmonary contusion following a lithotripsy for a left kidney stone and whose evolution was favourable after two weeks in intensive care unit. Through this observation and the analysis of the rare reported cases in the literature, we insist on the different varieties of pulmonary complications of the ESWL, the hypothesis explaining the mechanisms of their arising as well as the precautions to take to avoid them.

  4. Stenting and extracorporeal shock wave lithotripsy in chronic pancreatitis

    DEFF Research Database (Denmark)

    Holm, M; Matzen, Peter

    2003-01-01

    BACKGROUND: Early observational studies of endoscopic treatment and extracorporeal shock wave lithotripsy (ESWL) reported considerable or complete relief of pain in 50%-80% of patients with chronic pancreatitis. There is no consensus on the measurement of pain, making comparison of observational...... studies difficult, and little attention has been paid to the type and amount of analgesics used by patients before and after decompressive treatment. METHODS: We performed a retrospective study of all patients with chronic pancreatitis and large-duct disease and receiving decompressing treatment between 1...... November 1994 and 31 July 1999. Primary parameters were type and amount of analgesics used. RESULTS: Forty-nine patients with chronic pancreatitis and large-duct disease received stenting of the pancreatic duct (28 patients), ESWL (6 patients) or both (15 patients). After a median follow-up of 21 months...

  5. The use of extracorporeal life support in adolescent amlodipine overdose

    Directory of Open Access Journals (Sweden)

    Elizabeth A Persad

    2012-01-01

    Full Text Available Calcium channel blocker (CCB toxicity is associated with refractory hypotension and can be fatal. A 13 year old young woman presented to the emergency department(ED six hours after an intentional overdose of amlodipine, barbiturates, and alcohol. She remained extremely hypotensive despite the administration of normal saline and calcium chloride and despite infusions of norepinephrine, epinephrine, insulin, and dextrose. Due to increasing evidence of end organ dysfunction, Extracorporeal Life Support (ECLS was initiated 9 hours after presentation to the ED. The patient′s blood pressure and end organ function immediately improved after cannulation. She was successfully decannulated after 57 hours of ECLS and was neurologically intact. Patients with calcium channel blocker overdose who are resistant to medical interventions may respond favorably to early ECLS.

  6. Extracorporeal shock wave treatment for chronic lateral epicondylitis (tennis elbow).

    Science.gov (United States)

    Ho, C

    2007-01-01

    (1) Electrohydraulic, electromagnetic, or piezoelectric devices are used to translate energy into acoustic waves during extracorporeal shock wave treatment (ESWT) for chronic lateral epicondylitis (CLE) of the elbow (elbow tendonitis or tennis elbow). These waves may help to accelerate the healing process via an unknown mechanism. (2) Results from randomized controlled trials have been conflicting. Half of the studies showed statistically significant improvement in pain in the treatment group, and half of the studies had data showing no benefit over placebo for any measured outcomes. (3) Limited evidence shows that ESWT is cheaper than arthroscopic surgery, open surgery, and other conservative therapies, such as steroid infiltrations and physiotherapy, that continue for more than six weeks. (4) The lack of convincing evidence regarding its effectiveness does not support the use of ESWT for CLE.

  7. The use of extracorporeal life support in adolescent amlodipine overdose

    Science.gov (United States)

    Persad, Elizabeth A.; Raman, Lakshmi; Thompson, Marita T.; Sheeran, Paul W.

    2012-01-01

    Calcium channel blocker (CCB) toxicity is associated with refractory hypotension and can be fatal. A 13 year old young woman presented to the emergency department(ED) six hours after an intentional overdose of amlodipine, barbiturates, and alcohol. She remained extremely hypotensive despite the administration of normal saline and calcium chloride and despite infusions of norepinephrine, epinephrine, insulin, and dextrose. Due to increasing evidence of end organ dysfunction, Extracorporeal Life Support (ECLS) was initiated 9 hours after presentation to the ED. The patient's blood pressure and end organ function immediately improved after cannulation. She was successfully decannulated after 57 hours of ECLS and was neurologically intact. Patients with calcium channel blocker overdose who are resistant to medical interventions may respond favorably to early ECLS. PMID:23559727

  8. Extracorporeal membrane oxygenation in adults for severe acute respiratory failure.

    Science.gov (United States)

    Rozé, H; Repusseau, B; Ouattara, A

    2014-01-01

    The purpose of this review is to examine the indications of extracorporeal membrane oxygenation (ECMO) for severe acute respiratory distress syndrome (ARDS). This technique of oxygenation has significantly increased worldwide with the H1N1 flu pandemic. The goal of ECMO is to maintain a safe level of oxygenation and controlled respiratory acidosis under protective ventilation. The enthusiasm for ECMO should not obscure the consideration for potential associated complications. Before widespread diffusion of ECMO, new trials should test the efficacy of early initiation or CO2 removal in addition to, or even as an alternative to mechanical ventilation for severe ARDS. Copyright © 2014 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier SAS. All rights reserved.

  9. Effect of extracorporeal ultraviolet blood irradiation on blood cholesterol level

    Science.gov (United States)

    Zalesskaya, G. A.; Laskina, O. V.; Mitkovskaya, N. P.; Kirkovsky, V. V.

    2012-07-01

    We have studied the effect of extracorporeal ultraviolet blood irradiation on cholesterol metabolism in patients with cardiovascular diseases. We have carried out a comprehensive analysis of the spectral characteristics of blood and plasma, gas-exchange and oximetry parameters, and the results of a complete blood count and chemistry panel before and after UV blood irradiation. We have assessed the changes in concentrations of cholesterols (total cholesterol, low-density lipoprotein (LDL) cholesterol, triglycerides) in the blood of the patients in response to a five-day course of UV blood irradiation. The changes in the spectral characteristics of blood and plasma, the chemistry panel, the gas composition, and the fractional hemoglobin composition initiated by absorption of UV radiation are used to discuss the molecular mechanisms for the effect of therapeutic doses of UV radiation on blood cholesterols.

  10. Extracorporeal shockwave therapy for chronic proximal plantar fasciitis.

    Science.gov (United States)

    Strash, Walter W; Perez, Richard R

    2002-10-01

    Although much enthusiasm surrounds applying extracorporeal shock wave therapy for various musculoskeletal conditions, its effects are not well understood and warrant continued study. Certain body tissues or organs may be damaged either acutely or chronically by ESWT; however, it is unequivocal that lung tissue may be damaged. It is theorized that neovascularization is responsible for improvement in symptoms of plantar fasciitis. Neovascularization is the direct effect of macrophage stimulation through cytokines. ESWT has effects at the cellular level--does it interfere with metabolic activity or enhance it? The noninvasive nature and minimal complications of appropriately applied ESWT are its primary advantages. Symptoms may continue to improve for three weeks to six months after treatment; the effects of shock wave therapy seem to be time dependent. ESWT is an effective form of treatment for proximal insertional plantar fasciitis after exhaustive, conservative forms of treatment have failed.

  11. Extracorporeal piezoelectric lithotripsy for retained bile duct stones.

    Science.gov (United States)

    Weber, J; Adamek, H E; Riemann, J F

    1992-05-01

    Extracorporeal piezoelectric shock wave lithotripsy (EPL) was performed in 35 patients with endoscopically non-extractable stones. With this lithotripter, stones are visualized by ultrasound and shock waves are produced by a piezoelectric acoustic generator. The stones could be localized in 32 out of 35 patients. Fragmentation was achieved in 91.4% and complete stone removal in 77.1%. These results show that piezoelectric lithotripsy is also a useful method for the treatment of complicated bile duct stones, as already demonstrated for the electrohydraulically and electromagnetically generated shock waves systems. The piezoelectric system is especially useful in elderly and frail patients because no general anesthesia is needed and only 14% of cases require analgesia or sedation.

  12. Extracorporeal shock wave therapy in periodontics: A new paradigm.

    Science.gov (United States)

    Venkatesh Prabhuji, Munivenkatappa Lakshmaiah; Khaleelahmed, Shaeesta; Vasudevalu, Sujatha; Vinodhini, K

    2014-05-01

    The quest for exploring new frontiers in the field of medical science for efficient and improved treatment modalities has always been on a rise. Extracorporeal shock wave therapy (ESWT) has been enormously used in medical practice, principally, for the management of urolithiasis, cholelithiasis and also in various orthopedic and musculoskeletal disorders. The efficacy of ESWT in the stimulation of osteoblasts, fibroblasts, induction of neovascularization and increased expression of bone morphogenic proteins has been well documented in the literature. However, dentistry is no exception to this trend. The present article enlightens the various applications of ESWT in the field of dentistry and explores its prospective applications in the field of periodontics, and the possibility of incorporating the beneficial properties of shock waves in improving the treatment outcome.

  13. Extracorporeal shock wave therapy in periodontics: A new paradigm

    Directory of Open Access Journals (Sweden)

    Munivenkatappa Lakshmaiah Venkatesh Prabhuji

    2014-01-01

    Full Text Available The quest for exploring new frontiers in the field of medical science for efficient and improved treatment modalities has always been on a rise. Extracorporeal shock wave therapy (ESWT has been enormously used in medical practice, principally, for the management of urolithiasis, cholelithiasis and also in various orthopedic and musculoskeletal disorders. The efficacy of ESWT in the stimulation of osteoblasts, fibroblasts, induction of neovascularization and increased expression of bone morphogenic proteins has been well documented in the literature. However, dentistry is no exception to this trend. The present article enlightens the various applications of ESWT in the field of dentistry and explores its prospective applications in the field of periodontics, and the possibility of incorporating the beneficial properties of shock waves in improving the treatment outcome.

  14. Liver Transplant

    Science.gov (United States)

    ... Liver Disease & NASH Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Biliary Atresia Cirrhosis Hemochromatosis Hepatitis A through E (Viral Hepatitis) Hepatitis ...

  15. Liver anatomy.

    Science.gov (United States)

    Abdel-Misih, Sherif R Z; Bloomston, Mark

    2010-08-01

    Understanding the complexities of the liver has been a long-standing challenge to physicians and anatomists. Significant strides in the understanding of hepatic anatomy have facilitated major progress in liver-directed therapies--surgical interventions, such as transplantation, hepatic resection, hepatic artery infusion pumps, and hepatic ablation, and interventional radiologic procedures, such as transarterial chemoembolization, selective internal radiation therapy, and portal vein embolization. Without understanding hepatic anatomy, such progressive interventions would not be feasible. This article reviews the history, general anatomy, and the classification schemes of liver anatomy and their relevance to liver-directed therapies. Copyright 2010 Elsevier Inc. All rights reserved.

  16. Quantification of Postmembrane Gaseous Microembolization During Venoarterial Extracorporeal Membrane Oxygenation.

    Science.gov (United States)

    Jiao, York; Gipson, Keith E; Bonde, Pramod; Mangi, Abeel; Hagberg, Robert; Rosinski, David J; Gross, Jeffrey B; Schonberger, Robert B

    2017-05-23

    Prolonged use of venoarterial extracorporeal membrane oxygenation (VA ECMO) may be complicated by end-organ dysfunction. Although gaseous microemboli (GME) are thought to damage end organs during cardiopulmonary bypass, patient exposures to GME have not been well characterized during VA ECMO. We therefore performed an observational study of GME in adult VA ECMO patients, with correlation to clinical events during routine patient care. After institutional review board (IRB) approval, we used two Doppler probes to detect GME noninvasively in extracorporeal membrane oxygenation (ECMO) circuits on four patients for 15 hours total while also recording patient care events. We then conducted in vitro trials to compare Doppler signals with gold-standard measurements using an Emboli Detection and Classification (EDAC) quantifier (Terumo Cardiovascular, Ann Arbor, MI) during simulated clinical interventions. Correlations between Doppler and EDAC data were used to estimate GME counts and volumes represented by clinical Doppler data. A total of 503 groups of Doppler peaks representing GME showers were observed, including 194 statistically larger showers during patient care activities containing 92% of total Doppler peaks. Intravenous injections accounted for an estimated 68% of GME and 88% of GME volume, whereas care involving movement accounted for an estimated 6% of GME and 3% of volume. Overall estimated embolic rates of 24,000 GME totaling 4 μl/hr rivals reported GME rates during cardiopulmonary bypass. Numerous GME are present in the postmembrane circuit during VA ECMO, raising concern for effects on microcirculation and organ dysfunction. Strategies to detect and minimize GME may be warranted to limit embolic exposures experienced by VA ECMO patients.

  17. A novel extracorporeal kidney perfusion system: a concept model.

    Science.gov (United States)

    Szajer, Michael; Shah, Gaurang; Kittur, Dilip; Searles, Bruce; Li, Lu; Bruch, David; Darling, Edward

    2004-01-01

    The number of patients awaiting kidney transplantation has more than doubled in the past decade while the number of available donor organs has seen only a modest increase, leading to a critical shortage of organs. In response to this extreme shortage, the criteria for accepting organs have been modified to include marginal donors such as non-heart beating donors (NHBD). In these kidneys, determining viability is important for success of transplantation. Therefore, a study was undertaken to develop a system that would allow the extracorporeal assessment of function and compatibility of the donor organ before the patient is exposed to the risks associated with surgery. Following bilateral nephrectomy, the kidneys of 10 pigs (approximately 30 kg) were connected to a commercially available hypothermic pulsatile kidney perfusion apparatus. This system was modified to allow for normothermic pulsatile renal perfusion using the potential recipient's blood, via vascular access. These kidneys were perfused with the animal's blood for a minimum of two hours while various parameters were monitored. Perfusion pressures were kept between 60 and 90 mmHg, which correlated to flows between 70 and 150 mL/min. A decrease in perfusion pressure with a concomitant rise in flow over the two-hour period served as a good predictor of a viable and compatible graft. The modified kidney preservation system allows the normothermic, pulsatile extracorporeal perfusion of donor kidneys with the ability to monitor resistance to flow and urine production. This model also allows observation of the kidney for signs of hyperacute rejection. Further research needs to be conducted in order to determine if the system represents a methodology to increase the pool of available donor organs.

  18. Extracorporeal albumin dialysis with the molecular adsorbent recirculating system in acute-on-chronic liver failure

    DEFF Research Database (Denmark)

    Bañares, Rafael; Nevens, Frederik; Larsen, Fin Stolze;

    2013-01-01

    .87, 95% confidence interval [CI] 0.44-1.72). MELD score and HE at admission and the increase in serum bilirubin at day 4 were independent predictors of death. At day 4, a greater decrease in serum creatinine (P=0.02) and bilirubin (P=0.001) and a more frequent improvement in HE (from grade II-IV to grade...

  19. UniPron is A Fully Effective Non-hormonal Reversible Contraceptive in Baboon Model(Papio Anubis)

    Institute of Scientific and Technical Information of China (English)

    Jael A.Obiero; Maureen N.Mburu; Benson M.Ndung'u; Kenneth K.Waititu; Isaac Mulei; Idle O.Farah; Peter G.Mwethera

    2008-01-01

    Objective To determine the safety and efficacy of UniPron as a reversible contraceptive.Methods Vaginal swabs were obtained before and after UniPron administration.cultured onto appropriate culture media and bacteria identification was done based on type of media used,Gram stain reactions,colony morphology and biochemical tests.Vaginal biopsy tissues were processed using paraffin wax method,stained with hematoxylin and eosin and examined under light microscopy to determine the effect of the product on vaginal tissues.The effect of UniPron on sperm was examined by mixing the product with electroejaculated spermatozoa in vitro at different concentrations.For efficacy studies,male baboons of proven fertility were mated with UniPron treated or untreated females of proven fertility during the fertile stages.Results All the five females(100%)that were treated with UniPron did not conceive and they regained total fertitity when the treatment was stopped while all the controls conceived.At a concentration of 40%,UniPron completely immobilized spermatozoa in an in-vitro system.UniPron mechanism of action was by lowering the vaginal pH and on application in baboon,the pH was lowered for at least 3 h after which it went back to normal.Conclusions As we plan for a study to test UniPron as a microbicide to prevent STIs including HIV,our current study has established that this novel product is effective in contraception and harmless to vaginal tissues and vaginal microbial flora in a baboon model(Papio anubis).

  20. The role of cromakalim and a nitric oxide synthase blocker in cardiac arrhythmia in the intact baboon model.

    Science.gov (United States)

    Hay, L; Schutte, P J; Du Plooy, W J; Kahler, C P

    2000-02-01

    The arrhythmogenic effect of adenosine triphosphate (ATP)-sensitive potassium channel openers is controversial and may be dependent on the type of animal model used. Information on the effect of these drugs in the normal primate model is limited. The purpose of this study was first to determine the arrhythmogenic properties of cromakalim in the baboon and second to determine whether N-omega-nitro-L-arginine methyl ester (L-NAME) has any effect on the induced arrhythmia. Adult (2-4 years old) baboons (Papio ursinus) were anesthetized with a continuous i.v. infusion of ketamine (100 mg/ ml), diazepam (5 mg/ml), and saline (ratio 2:2:50) at a rate of 40-60 ml/h. Sympathetic responses were inhibited by administration of propranolol (1 mg/kg) before the start of the experiments. Cromakalim (30 microg/kg) was administered before and after L-NAME (7.5 mg/kg), and the parameters were monitored for 15 min after each intervention. A Millar double-tipped microcatheter was used to record left ventricular and aortic pressures. Lead II of the ECG was monitored. During a 15-min period after administration of cromakalim, 22.3 +/- 6.0 abnormal ventricular complexes were recorded. L-NAME administration significantly reduced these abnormal complexes to 4.5 +/- 2 (paired t test, p < or = 0.05). We therefore conclude that cromakalim has arrhythmogenic properties in the baboon and that these can be attenuated by L-NAME.

  1. Liver spots

    Science.gov (United States)

    Liver spots are changes in skin color that occur in older skin. The coloring may be due to aging, exposure to the sun or other sources of ultraviolet light, or causes that are not known. Liver spots are very common after age 40. They occur ...

  2. Engineering analysis and development of the spheroid reservoir bioartificial liver.

    Science.gov (United States)

    McIntosh, Malcolm B; Corner, Stephen M; Amiot, Bruce P; Nyberg, Scott L

    2009-01-01

    A significant demand exists for a liver support device such as a Bioartifical Liver (BAL) to treat patients experiencing acute liver failure. This descriptive paper outlines the design and development of two of the key components of the Mayo Spheroid Reservoir Bioartificial Liver (SRBAL) system. One of the components is the multifunctional Spheroid Reservoir and the other is Multi-shelf Rocker. The Spheroid Reservoir provides an environment to support the viability and functionality of the hepatocyte spheroids at very high cell densities. The Spheroid Reservoir is the biologically active component of this extracorporeal liver support device. Since the Spheroid Reservoir is designed to support 200-400 grams of hepatocyte spheroids, a method to quickly produce large quantities of spheroids is required. The Multi-Shelf Rocker fulfills the production requirement by allowing the culturing of up to six liters of hepatocyte suspension in a conventional laboratory incubator. The SRBAL is designed to provide life sustaining liver-like function to patients in acute liver failure.

  3. The enzyme linked immunosorbent assay (ELISA) for the determination of circulating antigen and antibody in Schistosoma haematobium-infected baboons.

    Science.gov (United States)

    Ismail, M M; James, C; Webbe, G

    1981-01-01

    The ELISA was used to measure circulating antigen and antibody in four baboons of which three were treated. The circulating antigen appeared earlier after infection than the antibody which eventually, however, reached a higher level. Both antigen and antibody levels increased slightly after treatment and thereafter declined to reach background levels eight weeks later. It is concluded that the ELISA has a potentially useful role in detecting both antibody and circulating antigen and that it may be successfully used in evaluating the efficacy of schistosomicides.

  4. Pulp response to collagen and glutaraldehyde in pulpotomized primary teeth of baboons.

    Science.gov (United States)

    Fuks, A B; Jones, P C; Michaeli, Y; Bimstein, E

    1991-01-01

    This investigation assessed histologically the pulp tissue reaction to glutaraldehyde (GA) and to a commercial collagen preparation in pulpotomized primary teeth of baboons. One hundred and eighty-eight primary teeth were pulpotomized; in half of them inflammation was induced prior to the treatment. The teeth were divided into five groups: in three of them GA was used as a pulp dressing and applied for 1 min (group 1), 5 min (group 2), or mixed into the paste (group 3); collagen was used in group 4 and in group 5 (control) IRM was placed directly over the pulp stumps. Follow-up times were two, eight, and 24 weeks. Total necrosis was observed only in the collagen group. Partial necrosis and severe inflammation also were seen mainly in this group, and when the GA was incorporated into the paste. Slight to moderate inflammation was evident in all groups two and eight weeks postoperatively; however, 78% of the teeth of group 2 (GA 5 min) were inflammation-free after 24 weeks. Partial dentin bridges were seen in 92% of the teeth of the control group, in 82% of group 2, and 50% each of groups 1 and 3 eight weeks postoperatively. Dentin bridges were present in only 4% of the collagen group. After 24 weeks, all the teeth in group 2 and 83% of group 1 had dentin bridges. We conclude that Zyderm (Colagen Corp. Palo Alto, CA) led to unacceptable results, 5 min application of GA presented the best healing response, and GA 1 min and IRM also were satisfactory.

  5. The effect of excluding juveniles on apparent adult olive baboons (Papio anubis) social networks

    Science.gov (United States)

    Fedurek, Piotr; Lehmann, Julia

    2017-01-01

    In recent years there has been much interest in investigating the social structure of group living animals using social network analysis. Many studies so far have focused on the social networks of adults, often excluding younger, immature group members. This potentially may lead to a biased view of group social structure as multiple recent studies have shown that younger group members can significantly contribute to group structure. As proof of the concept, we address this issue by investigating social network structure with and without juveniles in wild olive baboons (Papio anubis) at Gashaka Gumti National Park, Nigeria. Two social networks including all independently moving individuals (i.e., excluding dependent juveniles) were created based on aggressive and grooming behaviour. We used knockout simulations based on the random removal of individuals from the network in order to investigate to what extent the exclusion of juveniles affects the resulting network structure and our interpretation of age-sex specific social roles. We found that juvenile social patterns differed from those of adults and that the exclusion of juveniles from the network significantly altered the resulting overall network structure. Moreover, the removal of juveniles from the network affected individuals in specific age-sex classes differently: for example, including juveniles in the grooming network increased network centrality of adult females while decreasing centrality of adult males. These results suggest that excluding juveniles from the analysis may not only result in a distorted picture of the overall social structure but also may mask some of the social roles of individuals belonging to different age-sex classes. PMID:28323851

  6. Effects of inhaled CO administration on acute lung injury in baboons with pneumococcal pneumonia

    Science.gov (United States)

    Kraft, Bryan D.; Hess, Dean R.; Harris, R. Scott; Wolf, Monroe A.; Suliman, Hagir B.; Roggli, Victor L.; Davies, John D.; Winkler, Tilo; Stenzler, Alex; Baron, Rebecca M.; Thompson, B. Taylor; Choi, Augustine M.; Welty-Wolf, Karen E.; Piantadosi, Claude A.

    2015-01-01

    Inhaled carbon monoxide (CO) gas has therapeutic potential for patients with acute respiratory distress syndrome if a safe, evidence-based dosing strategy and a ventilator-compatible CO delivery system can be developed. In this study, we used a clinically relevant baboon model of Streptococcus pneumoniae pneumonia to 1) test a novel, ventilator-compatible CO delivery system; 2) establish a safe and effective CO dosing regimen; and 3) investigate the local and systemic effects of CO therapy on inflammation and acute lung injury (ALI). Animals were inoculated with S. pneumoniae (108-109 CFU) (n = 14) or saline vehicle (n = 5); in a subset with pneumonia (n = 5), we administered low-dose, inhaled CO gas (100–300 ppm × 60–90 min) at 0, 6, 24, and/or 48 h postinoculation and serially measured blood carboxyhemoglobin (COHb) levels. We found that CO inhalation at 200 ppm for 60 min is well tolerated and achieves a COHb of 6–8% with ambient CO levels ≤ 1 ppm. The COHb level measured at 20 min predicted the 60-min COHb level by the Coburn-Forster-Kane equation with high accuracy. Animals given inhaled CO + antibiotics displayed significantly less ALI at 8 days postinoculation compared with antibiotics alone. Inhaled CO was associated with activation of mitochondrial biogenesis in the lung and with augmentation of renal antioxidative programs. These data support the feasibility of safely delivering inhaled CO gas during mechanical ventilation and provide preliminary evidence that CO may accelerate the resolution of ALI in a clinically relevant nonhuman primate pneumonia model. PMID:26320156

  7. Extracorporeal Membrane Oxygenation in a Patient With Refractory Acute Respiratory Distress Syndrome Secondary to Toxic Epidermal Necrolysis.

    Science.gov (United States)

    2014-12-01

    life support (ECLS) in adults with acute respiratory distress syndrome (ARDS) has increased markedly during the past few years after suc- cessful...Extracorporeal Membrane Oxygenation in a Patient With Refractory Acute Respiratory Distress Syndrome Secondary to Toxic Epidermal Necrolysis Christy...COVERED - 4. TITLE AND SUBTITLE Extracorporeal Membrane Oxygenation in a Patient With Refractory Acute Respiratory Distress Syndrome Secondary to

  8. Haplotypes in the APOA1-C3-A4-A5 gene cluster affect plasma lipids in both humans and baboons

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Qian-fei; Liu, Xin; O' Connell, Jeff; Peng, Ze; Krauss, Ronald M.; Rainwater, David L.; VandeBerg, John L.; Rubin, Edward M.; Cheng, Jan-Fang; Pennacchio, Len A.

    2003-09-15

    Genetic studies in non-human primates serve as a potential strategy for identifying genomic intervals where polymorphisms impact upon human disease-related phenotypes. It remains unclear, however, whether independently arising polymorphisms in orthologous regions of non-human primates leads to similar variation in a quantitative trait found in both species. To explore this paradigm, we studied a baboon apolipoprotein gene cluster (APOA1/C3/A4/A5) for which the human gene orthologs have well established roles in influencing plasma HDL-cholesterol and triglyceride concentrations. Our extensive polymorphism analysis of this 68 kb gene cluster in 96 pedigreed baboons identified several haplotype blocks each with limited diversity, consistent with haplotype findings in humans. To determine whether baboons, like humans, also have particular haplotypes associated with lipid phenotypes, we genotyped 634 well characterized baboons using 16 haplotype tagging SNPs. Genetic analysis of single SNPs, as well as haplotypes, revealed an association of APOA5 and APOC3 variants with HDL cholesterol and triglyceride concentrations, respectively. Thus, independent variation in orthologous genomic intervals does associate with similar quantitative lipid traits in both species, supporting the possibility of uncovering human QTL genes in a highly controlled non-human primate model.

  9. Early graft failure of GalTKO pig organs in baboons is reduced by expression of a human complement pathway-regulatory protein.

    Science.gov (United States)

    Azimzadeh, Agnes M; Kelishadi, Sean S; Ezzelarab, Mohamed B; Singh, Avneesh K; Stoddard, Tiffany; Iwase, Hayato; Zhang, Tianshu; Burdorf, Lars; Sievert, Evelyn; Avon, Chris; Cheng, Xiangfei; Ayares, David; Horvath, Keith A; Corcoran, Philip C; Mohiuddin, Muhammad M; Barth, Rolf N; Cooper, David K C; Pierson, Richard N

    2015-01-01

    We describe the incidence of early graft failure (EGF, defined as loss of function from any cause within 3 days after transplant) in a large cohort of GalTKO pig organs transplanted into baboons in three centers, and the effect of additional expression of a human complement pathway-regulatory protein, CD46 or CD55 (GalTKO.hCPRP). Baboon recipients of life-supporting GalTKO kidney (n = 7) or heterotopic heart (n = 14) grafts received either no immunosuppression (n = 4), or one of several partial or full immunosuppressive regimens (n = 17). Fourteen additional baboons received a GalTKO.hCPRP kidney (n = 5) or heart (n = 9) and similar treatment regimens. Immunologic, pathologic, and coagulation parameters were measured at frequent intervals. EGF of GalTKO organs occurred in 9/21 baboons (43%). hCPRP expression reduced the GalTKO EGF incidence to 7% (1/14; P organs in which EGF developed (P organ failure, and (iii) the expression of a hCPRP reduces EGF but does not prevent systemic coagulation activation. Additional strategies will be required to control coagulation activation.

  10. Remote cannulation and extracorporeal membrane oxygenation transport is safe in a newly established program

    Science.gov (United States)

    Grenda, David S.; Moll, Vanessa; Kalin, Craig M.

    2017-01-01

    Extracorporeal membrane oxygenation (ECMO) has become an increasingly utilized modality for the support of patients with severe cardiac or pulmonary dysfunction. Unfortunately, the costs and expertise required to maintain a formal ECMO program preclude the vast majority of hospitals from employing such technology routinely. These barriers to implementation of an effective ECMO program highlight the importance of the safe transport of patients in need of extracorporeal support. While many centers with extensive expertise in the management of patients on extracorporeal support have demonstrated their ability to transport those same patients, the ability of new ECMO programs to provide such transportation remains poorly studied. We established an ECMO program at our institution and immediately provided equipment and personnel to transport patients in need of or receiving extracorporeal support to our institution. Overall, we found that 13 out of 28 patients transported to our institution on ECMO or for consideration of ECMO support during the first 15 months of the program survived to hospital discharge. During that period, four incidents associated with patient transport occurred but none were related to ECMO support or adversely affected patient outcome. These observations demonstrate that new ECMO programs can safely and reliably transport patients on or in need of extracorporeal support. PMID:28275616

  11. Radial Extracorporeal Shock Wave Therapy in a Person With Advanced Osteonecrosis of the Femoral Head.

    Science.gov (United States)

    Ma, Yue Wen; Jiang, Dong Lei; Zhang, Dai; Wang, Xiao Bei; Yu, Xiao Tong

    2016-09-01

    This case report describes the first patient with avascular necrosis of the femoral head of Association Research Circulation Osseous stage IV, treated with radial extracorporeal shock wave therapy. By contrast, previous studies demonstrated the efficacy of a single treatment of focused extracorporeal shock wave therapy in improving pain and Harris Hip Scale in patients with avascular necrosis of the femoral head of Association Research Circulation Osseous stage I to III. The affected hip was treated with 6000 impulses of radial extracorporeal shock wave therapy at 10 Hz and an intensity ranging from 2.5 to 4.0 bar at 7-day intervals for 24 mos. The Harris Hip Scale values were 33, 43, 56, 77, 81, 88, and 92 at baseline and 1, 3, 6, 12, 18, and 24 mos, respectively. The radiographs showed that the subluxation of the right hip was slightly aggravated. Joint effusion was reduced, bone marrow edema disappeared, the density became more uniform, and the gluteal muscles were more developed based on magnetic resonance imaging. Increased tracer uptake was evident along the joint margin and superolateral aspect of the head both before and after radial extracorporeal shock wave therapy. This case report demonstrates the feasibility of long-term radial extracorporeal shock wave therapy in Association Research Circulation Osseous stage IV patients.

  12. Development of an Extracorporeal Perfusion Device for Small Animal Free Flaps.

    Directory of Open Access Journals (Sweden)

    Andreas M Fichter

    Full Text Available Extracorporeal perfusion (ECP might prolong the vital storage capabilities of composite free flaps, potentially opening a wide range of clinical applications. Aim of the study was the development a validated low-cost extracorporeal perfusion model for further research in small animal free flaps.After establishing optimal perfusion settings, a specially designed extracorporeal perfusion system was evaluated during 8-hour perfusion of rat epigastric flaps followed by microvascular free flap transfer. Controls comprised sham-operation, ischemia and in vivo perfusion. Flaps and perfusate (diluted blood were closely monitored by blood gas analysis, combined laser Doppler flowmetry and remission spectroscopy and Indocyanine-Green angiography. Evaluations were complemented by assessment of necrotic area and light microscopy at day 7.ECP was established and maintained for 8 hours with constant potassium and pH levels. Subsequent flap transfer was successful. Notably, the rate of necrosis of extracorporeally perfused flaps (27% was even lower than after in vivo perfusion (49%, although not statistically significant (P = 0,083. After sham-operation, only 6% of the total flap area became necrotic, while 8-hour ischemia led to total flap loss (98%. Angiographic and histological findings confirmed these observations.Vital storage capabilities of microvascular flaps can be prolonged by temporary ECP. Our study provides important insights on the pathophysiological processes during extracorporeal tissue perfusion and provides a validated small animal perfusion model for further studies.

  13. Development of an Extracorporeal Perfusion Device for Small Animal Free Flaps

    Science.gov (United States)

    Fichter, Andreas M.; Ritschl, Lucas M.; Borgmann, Anna; Humbs, Martin; Luppa, Peter B.; Wolff, Klaus-Dietrich; Mücke, Thomas

    2016-01-01

    Background Extracorporeal perfusion (ECP) might prolong the vital storage capabilities of composite free flaps, potentially opening a wide range of clinical applications. Aim of the study was the development a validated low-cost extracorporeal perfusion model for further research in small animal free flaps. Methods After establishing optimal perfusion settings, a specially designed extracorporeal perfusion system was evaluated during 8-hour perfusion of rat epigastric flaps followed by microvascular free flap transfer. Controls comprised sham-operation, ischemia and in vivo perfusion. Flaps and perfusate (diluted blood) were closely monitored by blood gas analysis, combined laser Doppler flowmetry and remission spectroscopy and Indocyanine-Green angiography. Evaluations were complemented by assessment of necrotic area and light microscopy at day 7. Results ECP was established and maintained for 8 hours with constant potassium and pH levels. Subsequent flap transfer was successful. Notably, the rate of necrosis of extracorporeally perfused flaps (27%) was even lower than after in vivo perfusion (49%), although not statistically significant (P = 0,083). After sham-operation, only 6% of the total flap area became necrotic, while 8-hour ischemia led to total flap loss (98%). Angiographic and histological findings confirmed these observations. Conclusions Vital storage capabilities of microvascular flaps can be prolonged by temporary ECP. Our study provides important insights on the pathophysiological processes during extracorporeal tissue perfusion and provides a validated small animal perfusion model for further studies. PMID:26808996

  14. Testing the function of reconciliation and third-party affiliation for aggressors in hamadryas baboons (Papio hamadryas hamadryas).

    Science.gov (United States)

    Romero, Teresa; Colmenares, Fernando; Aureli, Filippo

    2009-01-01

    In social groups, agonistic conflicts can have different negative consequences. Several post-conflict interactions have been suggested as post-conflict management behaviors to mitigate those negative effects. In this study, we investigated the function of two post-conflict behaviors--reconciliation and aggressor-initiated third-party affiliation--on the aggressor's levels of post-conflict anxiety and aggression in a large colony of hamadryas baboons. We also examined variation in the aggressor's levels of post-conflict anxiety as a function of relationship quality between the opponents as predicted by the Integrated Hypothesis. We found that after conflicts hamadryas baboon aggressors showed increased rates of anxiety-related behaviors and that they were also more likely to be involved in renewed aggressive interactions. Although both reconciliation and aggressor-initiated third-party affiliation reduced the probability of receiving post-conflict aggression, only reconciliation reduced the rates of anxiety-related behaviors, suggesting that the aggressors' post-conflict anxiety might be owing mainly to the damage that the conflict causes to their relationship with the victim. Furthermore, aggressor's rates of post-conflict anxiety were higher after conflicts with individuals with whom they had a high-quality relationship, supporting the idea that levels of post-conflict anxiety mediate the occurrence of reconciliation depending on the quality of the relationship with former opponent as predicted by the Integrated Hypothesis.

  15. Particle deposition in a child respiratory tract model: in vivo regional deposition of fine and ultrafine aerosols in baboons.

    Science.gov (United States)

    Albuquerque-Silva, Iolanda; Vecellio, Laurent; Durand, Marc; Avet, John; Le Pennec, Déborah; de Monte, Michèle; Montharu, Jérôme; Diot, Patrice; Cottier, Michèle; Dubois, Francis; Pourchez, Jérémie

    2014-01-01

    To relate exposure to adverse health effects, it is necessary to know where particles in the submicron range deposit in the respiratory tract. The possibly higher vulnerability of children requires specific inhalation studies. However, radio-aerosol deposition experiments involving children are rare because of ethical restrictions related to radiation exposure. Thus, an in vivo study was conducted using three baboons as a child respiratory tract model to assess regional deposition patterns (thoracic region vs. extrathoracic region) of radioactive polydisperse aerosols ([d16-d84], equal to [0.15 µm-0.5 µm], [0.25 µm-1 µm], or [1 µm-9 µm]). Results clearly demonstrated that aerosol deposition within the thoracic region and the extrathoraic region varied substantially according to particle size. High deposition in the extrathoracic region was observed for the [1 µm-9 µm] aerosol (72% ± 17%). The [0.15 µm-0.5 µm] aerosol was associated almost exclusively with thoracic region deposition (84% ± 4%). Airborne particles in the range of [0.25 µm-1 µm] showed an intermediate deposition pattern, with 49% ± 8% in the extrathoracic region and 51% ± 8% in the thoracic region. Finally, comparison of baboon and human inhalation experiments for the [1 µm-9 µm] aerosol showed similar regional deposition, leading to the conclusion that regional deposition is species-independent for this airborne particle sizes.

  16. Particle deposition in a child respiratory tract model: in vivo regional deposition of fine and ultrafine aerosols in baboons.

    Directory of Open Access Journals (Sweden)

    Iolanda Albuquerque-Silva

    Full Text Available To relate exposure to adverse health effects, it is necessary to know where particles in the submicron range deposit in the respiratory tract. The possibly higher vulnerability of children requires specific inhalation studies. However, radio-aerosol deposition experiments involving children are rare because of ethical restrictions related to radiation exposure. Thus, an in vivo study was conducted using three baboons as a child respiratory tract model to assess regional deposition patterns (thoracic region vs. extrathoracic region of radioactive polydisperse aerosols ([d16-d84], equal to [0.15 µm-0.5 µm], [0.25 µm-1 µm], or [1 µm-9 µm]. Results clearly demonstrated that aerosol deposition within the thoracic region and the extrathoraic region varied substantially according to particle size. High deposition in the extrathoracic region was observed for the [1 µm-9 µm] aerosol (72% ± 17%. The [0.15 µm-0.5 µm] aerosol was associated almost exclusively with thoracic region deposition (84% ± 4%. Airborne particles in the range of [0.25 µm-1 µm] showed an intermediate deposition pattern, with 49% ± 8% in the extrathoracic region and 51% ± 8% in the thoracic region. Finally, comparison of baboon and human inhalation experiments for the [1 µm-9 µm] aerosol showed similar regional deposition, leading to the conclusion that regional deposition is species-independent for this airborne particle sizes.

  17. In vivo imaging of brain aromatase in female baboons: [11C]vorozole kinetics and effect of the menstrual cycle.

    Science.gov (United States)

    Pareto, Deborah; Biegon, Anat; Alexoff, David; Carter, Pauline; Shea, Coreen; Muench, Lisa; Xu, Youwen; Fowler, Joanna S; Kim, Sunny W; Logan, Jean

    2013-01-01

    The aim of this work was to quantify the brain distribution of the enzyme aromatase in the female baboon with positron emission tomography and the tracer [11C]vorozole using three different quantification methods for estimating the total distribution volume (V(T)): a graphical method, compartment modeling, and a tissue to plasma ratio. The graphical model and the compartment modeling gave similar estimates to the data and similar values (correlation R  =  .988; p  =  .0001). [11C]Vorozole shows a rapid uptake by the brain followed by a relatively constant accumulation, suggesting the possibility of using the tissue to plasma ratio as an estimate of V(T). The highest uptake of [11C]vorozole in the baboon brain was measured in the amygdala, followed by the preoptic area and hypothalamus, basal ganglia, and cortical areas. Pretreatment studies with vorozole or letrozole showed a generalized decrease in brain accumulation and V(T). The results suggested that the physiologic changes in gonadal hormone levels accompanying the menstrual cycle had a significant effect on brain aromatase V(T).

  18. Pharmacokinetics of Cefovecin in Cynomolgus Macaques (Macaca fascicularis), Olive Baboons (Papio anubis), and Rhesus Macaques (Macaca mulatto)

    Energy Technology Data Exchange (ETDEWEB)

    Raabe, Brigitte M.; Lovaglio, Jamie A.; Grover, GScott; Brown, Scott A.; Boucher, Joseph F.; Yuan, Yang; Civil, Jacqueline R.; Gillhouse, Kimberly A.; Stubbs, Makeida N.; Hoggatt, Amber F.; Halliday, Lisa C.; Fortman, Jeffrey D.

    2011-05-01

    Cefovecin sodium is a long-acting, third-generation, cephalosporin antibiotic approved for the treatment of skin infections in dogs and cats. The pharmacokinetic properties of cefovecin were evaluated in cynomolgus macaques (Macaca fascicularis), olive baboons (Papio anubis), and rhesus macaques (Macaca mulatto) by using a single-dose (8 mg/kg SC) dosing regimen. Plasma cefovecin concentrations were determined by using ultra-performance liquid chromatography with tandem mass spectrometry, and a noncompartmental model was used to determine pharmacokinetic parameters. The half-life of cefovecin was 4.95 {+-} 1.47 h in cynomolgus macaques, 9.17 {+-} 1.84 h in olive baboons, and 8.40 {+-} 2.53 h in rhesus macaques. These values are considerably lower than the half-lives previously published for dogs (133 h) and cats (166 h). The extended half-life of cefovecin in dogs and cats is speculated to be due to active reabsorption of drug in the kidney tubules because plasma clearance is well below the normal glomerular filtration rate. In nonhuman primates, renal clearance rates approximated plasma clearance rates, suggesting that active renal reabsorption of cefovecin does not occur in these species. The pharmacokinetic properties of cefovecin in nonhuman primates are vastly different from the pharmacokinetic properties in dogs and cats, precluding its use as a long-acting antibiotic in nonhuman primates. This study highlights the importance of performing pharmacokinetic studies prior to extralabel drug usage.

  19. Social affiliation matters: both same-sex and opposite-sex relationships predict survival in wild female baboons.

    Science.gov (United States)

    Archie, Elizabeth A; Tung, Jenny; Clark, Michael; Altmann, Jeanne; Alberts, Susan C

    2014-10-22

    Social integration and support can have profound effects on human survival. The extent of this phenomenon in non-human animals is largely unknown, but such knowledge is important to understanding the evolution of both lifespan and sociality. Here, we report evidence that levels of affiliative social behaviour (i.e. 'social connectedness') with both same-sex and opposite-sex conspecifics predict adult survival in wild female baboons. In the Amboseli ecosystem in Kenya, adult female baboons that were socially connected to either adult males or adult females lived longer than females who were socially isolated from both sexes--females with strong connectedness to individuals of both sexes lived the longest. Female social connectedness to males was predicted by high dominance rank, indicating that males are a limited resource for females, and females compete for access to male social partners. To date, only a handful of animal studies have found that social relationships may affect survival. This study extends those findings by examining relationships to both sexes in by far the largest dataset yet examined for any animal. Our results support the idea that social effects on survival are evolutionarily conserved in social mammals.

  20. Transcriptional regulation of proteoglycan 4 by 17β-estradiol in immortalized baboon temporomandibular joint disc cells.

    Science.gov (United States)

    McDaniel, Jennifer S; Akula Suresh Babu, Ramya; Navarro, Mary M; LeBaron, Richard G

    2014-04-01

    Temporomandibular joint disorders (TMDs) affect a significant portion of the population of the USA, with the majority of those seeking treatment being women of childbearing age. Owing to this striking sexual dimorphism it has been postulated that sex hormones play a role in the maintenance of normal temporomandibular joint (TMJ) function. Proteoglycan 4 (PRG4) is a secreted lubricating molecule required for maintaining low frictional levels within articular joints; however, its role in the TMJ is not well characterized. In this study we describe the development of immortalized baboon cells isolated from specific regions of the TMJ disc and their use in the investigation of PRG4 expression and localization patterns in the TMJ. We identified conserved estrogen response elements within the 5' flanking region of the PRG4 gene of several species, and found that treatment of baboon TMJ disc cells with estrogen led to reduced PRG4 promoter activity and reduced expression of PRG4 mRNA in vitro. The observed negative regulation of PRG4 by estrogen could lead to increased friction and degradation of joint components over time. This study, for the first time, provides evidence of the regulatory potential of estrogen on PRG4 gene expression and suggests a novel etiology for the gender disparity observed among TMD patients.

  1. Liver metastases

    Science.gov (United States)

    ... no symptoms. When symptoms occur, they may include: Decreased appetite Confusion Fever , sweating Jaundice (yellowing of the skin ... can include: Blockage of the flow of bile Decreased appetite Fever Liver failure (usually only in the late ...

  2. Liver Panel

    Science.gov (United States)

    ... GGT) – another enzyme found mainly in liver cells Lactate dehydrogenase (LD) – an enzyme released with cell damage; found ... and with conditions, such as congestive heart failure . Lactate dehydrogenase (LD) This is a non-specific marker of ...

  3. Liver function

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008308 Study on transplantation of induced bone marrow mesenchymal stem cells via a series of the treatment of chronic liver injury. SUN Yan(孙艳), et al. Dept Gastroenterol, 1st Hosp, Jilin Univ, Changchun 130021. Chin J Dig 2008;28(3):171-174.Objective To investigate the efficacy of transplantation of induced bone marrow mesenchymal stem cells(MSCs)via a series of treatment of chronic liver injury.Methods MSCs were isolated and expanded by density

  4. Safety and Outcomes of Extracorporeal Photopheresis With the Therakos Cellex System for Graft-Versus-Host Disease in Pediatric Patients.

    Science.gov (United States)

    Uygun, Vedat; Daloglu, Hayriye; Karasu, Gulsun; Hazar, Volkan; Yeşilipek, Akif

    2015-04-01

    Extracorporeal photopheresis (ECP) is a difficult procedure to perform in the pediatric population. This is a retrospective review of 12 pediatric patients who underwent photopheresis with the Therakos Cellex system for graft-versus-host disease (GVHD). Acute GVHD (aGVHD) occurred in 6 patients, and overlap syndrome and chronic GVHD (cGVHD) occurred in 4 and 2 patients, respectively. The ECP regimen was the same for all aGVHD and cGVHD patients: initially, every week (2 sessions/wk) for 2 months; next, every 2 weeks for 2 months; and finally, every month for at least 1 year. Improvement was observed in 7 of 10 aGVHD patients (70%) and in 4 of 6 cGVHD patients (66%). Eleven patients had skin involvement before ECP; 9 of them responded to treatment (81%). Gastrointestinal involvement occurred in 8 patients; 5 of them experienced improvement during ECP treatment (62%). All 4 patients with liver involvement failed to respond. No serious adverse reactions occurred. In conclusion, our study demonstrates that ECP with the Therakos Cellex system is a safe treatment option for GVHD in children, allowing the tapering of immunosuppressants by at least half.

  5. Activation of the baboon fetal hypothalamic-pituitary-adrenocortical axis at midgestation by estrogen-induced changes in placental corticosteroid metabolism

    Energy Technology Data Exchange (ETDEWEB)

    Pepe, G.J.; Waddell, B.J.; Albrecht, E.D. (Eastern Virginia Medical School, Norfolk (USA))

    1990-12-01

    We have hypothesized that the change in placental cortisol (F)-cortisone (E) metabolism induced by estrogen late in gestation is important to activation of the baboon fetal hypothalamic-pituitary-adrenocortical axis, culminating in the ontogenesis of de novo F secretion by the fetal adrenal. The present study tested this hypothesis in vivo by comparing the proportion of F in the fetus derived via maternal and fetal production on day 100 (n = 7; term = day 184) and day 165 (n = 4) in untreated baboons and on day 100 in baboons (n = 9) in which 50-mg pellets of androstenedione were implanted sc in the mother in increasing numbers (i.e. two on day 70, four on day 78, six on day 86, and eight on day 94) to increase placental estrogen production. Maternal, uterine, and umbilical venous samples were collected during constant maternal infusion (120 min) of (3H)F/(14C)E, endogenous and radiolabeled F/E content was determined, and corticosteroid dynamics were quantified. The MCR and peripheral interconversion of F and E as well as the production rate of F were unaltered in the mother. However, at midgestation, androstenedione increased (P less than 0.05) estrogen by 62% and altered transuterofeto placental F-E metabolism from preferential reduction of E to preferential oxidation of F, a pattern similar to that at term. In untreated baboons, on day 100 none of the F in the fetus was due to fetal production, whereas by day 165, 49 +/- 6% was of fetal origin. In animals treated with androstenedione at midgestation, 22 +/- 4% of fetal F was derived de novo within the fetus. Thus, production of F by the fetus was negligible on day 100, increased near term in association with an increase in transplacental oxidation of F to E, and was induced at midgestation in baboons in which placental F-E metabolism was altered by an increase in estrogen production.

  6. Vegetation classification as the basis for baboon management in the Bourke’s Luck Section of the Blyde Canyon Nature Reserve, Mpumalanga

    Directory of Open Access Journals (Sweden)

    L.R. Brown

    2005-12-01

    Full Text Available The Blyde Canyon Nature Reserve (BCNR was identified as an important conservation area due to of its extraordinary diversity of plant species. Plant communities represent ecosystems and form the basis of any management plan for natural areas. If these ecosystems and their different potentials are unknown, they cannot be managed successfully. Baboons exploit diverse habitats including human environments where they often cause damage to crops and forest plantations. Baboons are regarded as particularly problematic residents of protected areas as conventional fences do not readily enclose them, their eclectic diets allow them to benefit from a range of agricultural endeavours, and they are behaviourally opportunistic. Thus as a first step to implementing a conservation policy to manage chacma baboons in the BCNR, it was necessary to have some understanding of their exploitation of natural habitats adjacent to areas where they do cause problems. Although a broad vegetation map of the BCNR exists, no detailed vegetation studies have been conducted on the largest part of the reserve. It was therefore decided to ndertake a detailed vegetation study of the home range of a single baboon troop within the Bourke’s Luck section of the BCNR. From a TWINSPAN classification, refined by Braun-Blanquet procedures, 13 plant communities, which can be grouped into seven major groups, were identified. A classification and description of these communities, as well as a vegetation map are presented. Data collected as part of this study also revealed that the baboons show preference to certain communities whilst avoiding others. These have important consequences in terms of the management strategies followed on the reserve.

  7. [Individualised care plan during extracorporeal membrane oxygenation. A clinical case].

    Science.gov (United States)

    Call Mañosa, S; Pujol Garcia, A; Chacón Jordan, E; Martí Hereu, L; Pérez Tejero, G; Gómez Simón, V; Estruga Asbert, A; Gallardo Herrera, L; Vaquer Araujo, S; de Haro López, C

    2016-01-01

    An individualised care plan is described for a woman diagnosed with pneumonia, intubated, and on invasive mechanical ventilation, who was admitted to the Intensive Care Unit for extracorporeal membrane oxygenation (ECMO). A nursing care plan was designed based on Marjory Gordon functional patterns. The most important nursing diagnoses were prioritised, using a model of clinical reasoning model (Analysis of the current status) and NANDA taxonomy. A description is presented on, death anxiety, impaired gas exchange, decreased cardiac output, dysfunctional gastrointestinal motility, risk for disuse syndrome, infection risk, and bleeding risk. The principal objectives were: to reduce the fear of the family, achieve optimal respiratory and cardiovascular status, to maintain gastrointestinal function, to avoid immobility complications, and to reduce the risk of infection and bleeding. As regards activities performed: we gave family support; correct management of the mechanical ventilation airway, cardio-respiratory monitoring, skin and nutritional status; control of possible infections and bleeding (management of therapies, care of catheters…). A Likert's scale was used to evaluate the results, accomplishing all key performance indicators which were propose at the beginning. Individualised care plans with NNN taxonomy using the veno-venous ECMO have not been described. Other ECMO care plans have not used the same analysis model. This case can help nurses to take care of patients subjected to veno-venous ECMO treatment, although more cases are needed to standardise nursing care using NANDA taxonomy.

  8. Cannulation strategies for percutaneous extracorporeal membrane oxygenation in adults.

    Science.gov (United States)

    Napp, L Christian; Kühn, Christian; Hoeper, Marius M; Vogel-Claussen, Jens; Haverich, Axel; Schäfer, Andreas; Bauersachs, Johann

    2016-04-01

    Extracorporeal membrane oxygenation (ECMO) has revolutionized treatment of severe isolated or combined failure of lung and heart. Due to remarkable technical development the frequency of use is growing fast, with increasing adoption by interventional cardiologists independent of cardiac surgery. Nevertheless, ECMO support harbors substantial risk such as bleeding, thromboembolic events and infection. Percutaneous ECMO circuits usually comprise cannulation of two large vessels ('dual' cannulation), either veno-venous for respiratory and veno-arterial for circulatory support. Recently experienced centers apply more advanced strategies by cannulation of three large vessels ('triple' cannulation), resulting in veno-veno-arterial or veno-arterio-venous cannulation. While the former intends to improve drainage and unloading, the latter represents a very potent method to provide circulatory and respiratory support at the same time. As such triple cannulation expands the field of application at the expense of increased complexity of ECMO systems. Here, we review percutaneous dual and triple cannulation strategies for different clinical scenarios of the critically ill. As there is no unifying terminology to date, we propose a nomenclature which uses "A" and all following letters for supplying cannulas and all letters before "A" for draining cannulas. This general and unequivocal code covers both dual and triple ECMO cannulation strategies (VV, VA, VVA, VAV). Notwithstanding the technical evolution, current knowledge of ECMO support is mainly based on observational experience and mostly retrospective studies. Prospective controlled trials are urgently needed to generate evidence on safety and efficacy of ECMO support in different clinical settings.

  9. Venovenous Extracorporeal Membrane Oxygenation in Pediatric Respiratory Failure.

    Science.gov (United States)

    Ham, P Benson; Hwang, Brice; Wise, Linda J; Walters, K Christian; Pipkin, Walter L; Howell, Charles G; Bhatia, Jatinder; Hatley, Robyn

    2016-09-01

    Conventional treatment of respiratory failure involves positive pressure ventilation that can worsen lung damage. Extracorporeal membrane oxygenation (ECMO) is typically used when conventional therapy fails. In this study, we evaluated the use of venovenous (VV)-ECMO for the treatment of severe pediatric respiratory failure at our institution. A retrospective analysis of pediatric patients (age 1-18) placed on ECMO in the last 15 years (1999-2014) by the pediatric surgery team for respiratory failure was performed. Five pediatric patients underwent ECMO (mean age 10 years; range, 2-16). All underwent VV-ECMO. Diagnoses were status asthmaticus (2), acute respiratory distress syndrome due to septic shock (1), aspergillus pneumonia (1), and respiratory failure due to parainfluenza (1). Two patients had severe barotrauma prior to ECMO initiation. Average oxygenation index (OI) prior to cannulation was 74 (range 23-122). No patients required conversion to VA-ECMO. The average ECMO run time was 4.4 days (range 2-6). The average number of days on the ventilator was 15 (range 4-27). There were no major complications due to the procedure. Survival to discharge was 100%. Average follow up is 4.4 years (range 1-15). A short run of VV-ECMO can be lifesaving for pediatric patients in respiratory failure. Survival is excellent despite severely elevated oxygen indices. VV-ECMO may be well tolerated and can be considered for severe pediatric respiratory failure.

  10. Hemolysis-Associated Nitric Oxide Dysregulation during Extracorporeal Membrane Oxygenation

    Science.gov (United States)

    Sulkowski, Jason P.; Cooper, Jennifer N.; Pearson, Erik G.; Connelly, James T.; Rintoul, Natalie; Kilbaugh, Todd J.; Deans, Katherine J.; Minneci, Peter C.

    2014-01-01

    Abstract: Acute intravascular hemolysis during extracorporeal membrane oxygenation (ECMO) leads to increased levels of cell-free hemoglobin (FHb). Our aim was to investigate whether FHb levels are associated with nitric oxide (NO) consumption and clinical outcomes. A prospective observational study was performed involving pediatric patients on ECMO. Blood samples were collected before, during, and after the ECMO run, and plasma was evaluated for FHb, oxyhemoglobin, and NO consumption. Clinical data were collected including baseline patient characteristics, indications for ECMO, circuit changes, and mortality. Correlations between laboratory measures and associations between laboratory measures and clinical observations were evaluated. Twenty-three patients (11 male, 17 neonates) were enrolled with a median weight of 3.1 kg (interquartile range, 2.8–14.0 kg) and median ECMO run of 12 days (interquartile range, 5–19 day). There was a significant increase in FHb over time on ECMO (p = .007), and significant correlations were present between NO consumption and both FHb (r = .41, p = .01) and oxyhemoglobin levels (r = .98, p hemolysis and type of ECMO (venovenous versus venoarterial) or mortality. For children on ECMO, we observed a strong correlation between increased levels of plasma FHb and elevations in oxyhemoglobin and NO consumption; however, these changes were not associated with increased mortality. Increased hemolysis before circuit changes may be both a marker and a contributor to circuit failure. PMID:26357787

  11. Blood Transfusion Strategies in Patients Undergoing Extracorporeal Membrane Oxygenation

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    Hyoung Soo Kim

    2017-02-01

    Full Text Available Extracorporeal membrane oxygenation (ECMO is frequently associated with bleeding and coagulopathy complications, which may lead to the need for transfusion of multiple blood products. However, blood transfusions are known to increase morbidity and mortality, as well as hospital cost, in critically ill patients. In current practice, patients on ECMO receive a transfusion, on average, of 1-5 packed red blood cells (RBCs/day, with platelet transfusion accounting for the largest portion of transfusion volume. Generally, adult patients require more transfusions than neonates or children, and patients receiving venovenous ECMO for respiratory failure tend to need smaller transfusion volumes compared to those receiving venoarterial ECMO for cardiac failure. Observation studies have reported that a higher transfusion volume was associated with increased mortality. To date, the evidence for transfusion in patients undergoing ECMO is limited; most knowledge on transfusion strategies was extrapolated from studies in critically ill patients. However, current data support a restrictive blood transfusion strategy for ECMO patients, and a low transfusion trigger seems to be safe and reasonable.

  12. Risk factors for nosocomial infection during extracorporeal membrane oxygenation.

    Science.gov (United States)

    Hsu, M-S; Chiu, K-M; Huang, Y-T; Kao, K-L; Chu, S-H; Liao, C-H

    2009-11-01

    An increasing number of patients receive extracorporeal membrane oxygenation (ECMO) for life support. This study aimed to investigate the incidence and risk factors for nosocomial infection in adult patients receiving ECMO. We reviewed the medical records of adult patients who received ECMO support for more than 72h at Far Eastern Memorial Hospital from 2001 to 2007. ECMO-related nosocomial infections were defined as infections occurring from 24h after ECMO initiation until 48h after ECMO discontinuation. There were 12 episodes of nosocomial infection identified in 10 of the 114 (8.77%) patients on ECMO, including four cases of pneumonia, three cases of bacteraemia, three surgical site infections and two urinary tract infections. The incidence of ECMO-related nosocomial infection was 11.92 per 1000 ECMO-days. The length of ECMO use and intensive care unit (ICU) stay were significantly different between patients with, and without, nosocomial infection (Pnosocomial infection rate (P=0.003). Gram-negative bacilli were responsible for 78% of the nosocomial infections. In the univariate analysis, the duration of ICU stay and duration of ECMO use were associated with nosocomial infection. In the multivariate analysis, only the duration of ECMO was independently associated with nosocomial infection (P=0.007). Overall, the only independent risk factor for ECMO-related nosocomial infection identified in this study was prolonged ECMO use.

  13. Pressure Distribution for Piezoelectric Extracorporeal Shock Wave Lithotripsy

    Science.gov (United States)

    Yanagida, Yuji; Iwama, Nobuyuki; Okazaki, Kiyoshi

    1993-05-01

    The objective of this study is to develop a safer and more effective extracorporeal shock wave lithotripter. The first stage of the study shows the sound pressure field of the shock wave made by an ECHOLITH ESL-500A. The sound pressure distribution is in a ring configuration on a 60 mm plane in front of the focal plane. As the plane approaches the focal plane, the sound pressure relatively increases at the cross point with the axis of the transducer and decreases at the ring. The focal zone is 2.5 mm × 16.1 mm at 60 V driving voltage and 1.8 mm × 14.2 mm at “INTENSITY 2.” In the next stage we propose a method for changing the field by electronic driving control of each piezoceramic element for effective therapy. The focal zone can be changed from 3.1 mm × 19.1 mm to 3.9 mm × 32.4 mm at 60 V driving voltage with this method. These focal zones are calculated by means of computer simulation.

  14. EXTRACORPOREAL SHOCKWAVE THERAPY FOR POST BURN CARPAL TUNNEL SYNDROME

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    Hesham Galal Mahran

    2015-04-01

    Full Text Available Background: Carpal tunnel syndrome is considered the most common compression neuropathy of the upper extremity. It may lead to work disability and functional impairment. Burns are associated with swelling and eschar which forms a tight band constricting the circulation distally. Purpose: To investigate the effect of shockwave therapy on the carpal tunnel syndrome post burn. Subjects: Thirty male and female patients selected with manifestation of carpal tunnel syndrome post burn evaluated by electromyography, patients were divided randomly into two equal groups (A & B; group (A received shockwave therapy plus traditional physical therapy, while group (B received only traditional physical therapy (heating and stretching; Shock wave therapy protocol was two sessions per week for 12 weeks. Traditional physiotherapy was applied for both groups, 20 min for session 3times per week for 12 weeks. Evaluation: Electro diagnostic evaluation was done before treatment, one and three months post treatment. Results: There were improvement and significant increase in motor and sensory conduction velocities in shockwave group compared to those in the control group (p<0.05, also there were improvement and significant decrease in motor and sensory latencies in shockwave group compared to those in control group (p<0.05. Conclusion: Extracorporeal shockwave therapy provided a non-invasive, satisfied treatment option for carpal tunnel syndrome post burn.

  15. Effects of extracorporeal shock wave therapy on fracture nonunions.

    Science.gov (United States)

    Vulpiani, Maria C; Vetrano, Mario; Conforti, Federica; Minutolo, Lucia; Trischitta, Donatella; Furia, John P; Ferretti, Andrea

    2012-09-01

    The purpose of this study was to examine the effect of focused extracorporeal shock wave therapy (ESWT) on the treatment of nonunions. As part of a prospective study, we included 143 patients (average age, 41.4 years) with a diagnosis of nonunion (mean, 14.1 months; range, 6-84 months). High-energy shock wave treatment was applied using shock wave generator. The shock waves were applied in 3-5 sessions of 2500 to 3000 impulses each given at 0.25-0.84 mJ/mm(2), at intervals of 48-72 hours between sessions. A maximum of 3 cycles of treatment was given, at 3-month intervals. The patients were followed during a 12-month period until fracture healing or, in case of failure, until another therapy was adopted. Complete healing was observed in 80 of 143 cases (55.9%) at an average time of 7.6 months (range 2-24 months). Partial healing occurred in 41 cases (28.7%) and no healing was observed in 22 cases (15.4%). Patients with trophic nonunions had a better success rate than patients with atrophic nonunions (Pextracorporeal shock wave therapy is a safe and effective treatment for nonunion. ESWT is more effective for trophic nonunions than atrophic nonunions.

  16. Choreoathetosis after cardiac surgery with hypothermia and extracorporeal circulation.

    Science.gov (United States)

    Gherpelli, J L; Azeka, E; Riso, A; Atik, E; Ebaid, M; Barbero-Marcial, M

    1998-08-01

    Eleven children, 4-48 months old, with congenital cyanotic heart defects developed choreoathetoid movements 2-12 days after cardiac surgery with hypothermia and extracorporeal circulation (ECC). The abnormal movements mainly involved the limbs, facial musculature, and tongue, leading to a severe dysphagia. The symptoms had an acute onset, after a period of apparent neurologic normality, and had a variable outcome. Of the nine children that survive, three had abnormal movements when last seen (41 days to 12 months of follow-up). The other six children had a complete regression of the choreoathetoid movements 1-4 weeks after onset. No specific finding was observed in the CT scans, cerebrospinal fluid examination, or EEG that could be related to the abnormal movements. Symptomatic therapy with haloperidol with or without benzodiazepines led to symptomatic improvement in six children, although there was no evidence that this treatment modified the evolution of the disease. The authors conclude that the choreoathetoid syndrome after cardiac surgery with deep hypothermia and ECC is an ill-defined entity requiring additional study to better understand its pathogenesis so that preventive measures can be taken to avoid a condition that can lead to permanent and incapacitating neurologic sequelae.

  17. Shoulder function after extracorporal shock wave therapy for calcific tendinitis.

    Science.gov (United States)

    Rompe, J D; Bürger, R; Hopf, C; Eysel, P

    1998-01-01

    We report a controlled, prospective study that explored the effect of extracorporal shock waves of low- versus high-energy density in patients with chronic shoulder pain and calcific tendinitis. We assigned at random 100 patients who had had calcific tendinitis for more than 12 months to 2 groups to receive shock wave therapy either of a low- or high-energy density. Group 1 received 1500 impulses of 0.06 mJ/mm2, whereas group 2 received 1500 impulses of 0.28 mJ/mm2. Unlike group 1, in which the shock wave application could be performed without local anesthesia, all patients in group 2 required brachial plexus anesthesia. The patients were reviewed at 6 and 24 weeks. Partial or complete disintegration of the calcareous deposit was observed in 50% of the patients in group 1 and 64% of the patients in group 2 (P < .01). According to the Constant score, ratings increased from 48 to 71 points in group 1 (P < .001) and from 53 to 88 in group 2 (P < .001) (out of a total possible 100 points), the end values of both groups differing significantly (P < .01). After 24 weeks, 52% of the patients in group 1 rated the results of treatment as good or excellent, compared with 68% in group 2 (P < .01). No improvement was reported by 24% versus 10%, respectively, at the 24-week follow-up.

  18. Extracorporeal shock wave therapy for calcifying tendinitis of the shoulder.

    Science.gov (United States)

    Hsu, Chin-Jung; Wang, Der-Yean; Tseng, Kuo-Fung; Fong, Yi-Chin; Hsu, Horng-Chaung; Jim, Yick-Fung

    2008-01-01

    We prospectively studied extracorporeal shock wave therapy (ESWT) for calcific tendinitis of the shoulder in 46 consecutive patients. All patients were randomly divided into 2 groups: treatment and control. The 33 patients in the treatment group received 2 courses of ESWT at the energy density of 0.55 mJ/mm(2) (1000 impulses). The control group underwent sham treatment with a dummy electrode (13 patients). Evaluation included the Constant score, pain scale, and radiographs. The ESWT results were good to excellent in 87.9% of shoulders (29/33) and fair in 12.1% (4/33), and the control results were fair in 69.2% (9/13) and poor in 30.1% (4/13). Among ESWT patients, calcium deposits were completely eliminated in 7 cases (21.2%), partially eliminated in 11 (36.3%), and unchanged in 15 (45.4%). In contrast, elimination was partial in 2 control patients (15.3%) and unchanged in 11 (84.7%). There was no significant difference between Gärtner type I and type II groups in the Constant score (P > .05). ESWT shows promise for pain relief and functional restoration of calcific tendinitis with negligible complications.

  19. Radial extracorporeal shock wave treatment harms developing chicken embryos

    Science.gov (United States)

    Kiessling, Maren C.; Milz, Stefan; Frank, Hans-Georg; Korbel, Rüdiger; Schmitz, Christoph

    2015-01-01

    Radial extracorporeal shock wave treatment (rESWT) has became one of the best investigated treatment modalities for cellulite, including the abdomen as a treatment site. Notably, pregnancy is considered a contraindication for rESWT, and concerns have been raised about possible harm to the embryo when a woman treated with rESWT for cellulite is not aware of her pregnancy. Here we tested the hypothesis that rESWT may cause serious physical harm to embryos. To this end, chicken embryos were exposed in ovo to various doses of radial shock waves on either day 3 or day 4 of development, resembling the developmental stage of four- to six-week-old human embryos. We found a dose-dependent increase in the number of embryos that died after radial shock wave exposure on either day 3 or day 4 of development. Among the embryos that survived the shock wave exposure a few showed severe congenital defects such as missing eyes. Evidently, our data cannot directly be used to draw conclusions about potential harm to the embryo of a pregnant woman treated for cellulite with rESWT. However, to avoid any risks we strongly recommend applying radial shock waves in the treatment of cellulite only if a pregnancy is ruled out. PMID:25655309

  20. Pediatric extracorporeal shock wave lithotripsy: Predicting successful outcomes

    Directory of Open Access Journals (Sweden)

    Sean McAdams

    2010-01-01

    Full Text Available Extracorporeal shock wave lithotripsy (ESWL is currently a first-line procedure of most upper urinary tract stones <2 cm of size because of established success rates, its minimal invasiveness and long-term safety with minimal complications. Given that alternative surgical and endourological options exist for the management of stone disease and that ESWL failure often results in the need for repeat ESWL or secondary procedures, it is highly desirable to identify variables predicting successful outcomes of ESWL in the pediatric population. Despite numerous reports and growing experience, few prospective studies and guidelines for pediatric ESWL have been completed. Variation in the methods by which study parameters are measured and reported can make it difficult to compare individual studies or make definitive recommendations. There is ongoing work and a need for continuing improvement of imaging protocols in children with renal colic, with a current focus on minimizing exposure to ionizing radiation, perhaps utilizing advancements in ultrasound and magnetic resonance imaging. This report provides a review of the current literature evaluating the patient attributes and stone factors that may be predictive of successful ESWL outcomes along with reviewing the role of pre-operative imaging and considerations for patient safety.

  1. Veno-venous extracorporeal membrane oxygenation: cannulation techniques

    Science.gov (United States)

    Banfi, Carlo; Pozzi, Matteo; Siegenthaler, Nils; Brunner, Marie-Eve; Tassaux, Didier; Obadia, Jean-Francois; Bendjelid, Karim

    2016-01-01

    The development of extracorporeal membrane oxygenation (ECMO) technology allows a new approach for the intensive care management of acute cardiac and/or respiratory failure in adult patients who are not responsive to conventional treatment. Current ECMO therapies provide a variety of options for the multidisciplinary teams who are involved in the management of these critically ill patients. In this regard, veno-venous ECMO (VV-ECMO) can provide quite complete respiratory support, even if this highly complex technique presents substantial risks, such as bleeding, thromboembolic events and infection. While VV-ECMO circuits usually include the cannulation of two vessels (double cannulation) in its classic configuration, the use of a single cannula is now possible for VV-ECMO support. Recently, experienced centers have employed more advanced approaches by cannulating three vessels (triple cannulation) which follows veno-arterio-venous (VAV) or veno-arterio-pulmonary-arterial cannulation (VAPa). However, ‘triple’ cannulation expands the field of application but increases the complexity of ECMO systems. In the present review, the authors focus on the indications for VV-ECMO, patient assessment prior to cannulation, the role of ultrasound-guided vessel puncture, double lumen single bicaval cannulations, and finally triple cannulation in VV-ECMO. PMID:28149575

  2. [Extracorporeal shock wave therapy as a treatment of a non-healing chronic leg ulcer].

    Science.gov (United States)

    Stieger, M; Schmid, J-P; Bajrami, S; Hunziker, T

    2013-06-01

    Extracorporeal shock waves are defined as a sequence of sonic pulses characterized by high peak pressure over 100 MPa, fast pressure rise, and short lifecycle. In the 1980s extracorporeal shock wave lithotripsy (ESWL) was first used for the treatment of urolithiasis. Orthopedic surgeons use extracorporeal shock wave therapy (ESWT) to treat non-union fractures, tendinopathies and osteonecrosis. The first application of ESWT in dermatology was for recalcitrant skin ulcers. Several studies in the last 10 years have shown that ESWT promotes angiogenesis, increases perfusion in ischemic tissues, decreases inflammation, enhances cell differentiation and accelerates wound healing. We successfully treated a non-healing chronic venous leg ulcer with ESWT. Furthermore we observed an improvement of the lymphatic drainage after application of ESWT. We are confident that ESWT is a non-invasive, practical, safe and efficient physical treatment modality for recalcitrant leg ulcers.

  3. Fragmentation of common bile duct and pancreatic duct stones by extracorporeal shock-wave lithotripsy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ham Gyum [Ansan Junior College, Seoul (Korea, Republic of); Son, Soon Yong; Lee, Won Hong [Asan Medical Center, Seoul (Korea, Republic of)

    1998-06-01

    To determine its usefulness and safety of extracorporeal shock-wave lithotripsy in common bile duct and pancreatic duct stones, we analyzed the results of 13 patients with common bile duct stones and 6 patients with pancreatic duct stones which were removed by endoscopic procedures using the balloon or basket, who was performed the extracorporeal shock-wave lithotripsy using the ultrasonography for stone localization with a spark gap type Lithotriptor(Dornier MPL 9000, Germany). Fragmentation and complete clearance of the common bile duct and pancreatic duct stones were obtained in 19 of 19 patients(100%). Apart from transient attacks of fever in 2 of 13 patients with common bile duct stones(15%) and mild elevation of serum amylase and lipase in 2 of 6 patients with pancreatic duct stones(33%), no other serious side effects were observed. In our experiences, extracorporeal shock-wave lithotripsy is a safe and useful treatment for endoscopically unretrievable common bile duct and pancreatic duct stones.

  4. Combined application of extracorporeal membrane oxygenation and an artificial pacemaker in fulminant myocarditis in a child.

    Science.gov (United States)

    Ye, Sheng; Zhu, Lvchan; Ning, Botao; Zhang, Chenmei

    2017-06-01

    Fulminant myocarditis is severe and aggressive, but it is self-limited and usually has a favorable prognosis if the patients can survive the acute phase. When drug treatment is not effective, extracorporeal membrane oxygenation technology should be applied to support cardiopulmonary function. Extracorporeal membrane oxygenation can simultaneously support function of the left ventricle, right ventricle, and lungs, and provide stable blood circulation for patients with heart and respiratory failure, which allows sufficient time for the cardiopulmonary system to recover. Fulminant myocarditis affects cardiac systolic function, as well as the function of autorhythmic cells and the conduction system. If severe bradycardia or atrioventricular block appears, a pacemaker needs to be installed. We report a child with fulminant myocarditis who was treated with extracorporeal membrane oxygenation combined with an artificial pacemaker.

  5. Perspective of clinical application of pumpless extracorporeal lung assist (ECMO in newborn

    Directory of Open Access Journals (Sweden)

    Gandolfi José Francisco

    2003-01-01

    Full Text Available Extracorporeal lung assist (ECLA has been proposed as an invasive alternative to conventional treatment when oxygenation is not possible by rigorous mechanical ventilation alone. Usually, ECLA is carried out by establishing a venovenous or venoarterial shunt consisting of a roller or centrifugal pump, a membrane oxygenator, and a heat exchanger. However, the extracorporeal membrane oxygenation (ECMO with circulatory support lead hemolysis, coagulation disorders, inflammatory response, and specific technical complications inherent to a procedure of high risk and cost. To reduce the drawbacks of mechanical blood trauma during prolonged ECLA, the patient´s arteriovenous pressure gradient as the driving force for the blood flow through for the extracorporeal circuit can be used. In this article are analysed the main contributions of pumpless ECMO, used experimentally and in children and adults with respiratory failure, with perspective of clinical application in newborn.

  6. [The combination of extracorporeal lithotripsy and percutaneous nephrostomy in the treatment of obstructive ureteral urate calculi].

    Science.gov (United States)

    Del Boca, C; Ferrari, C; Dotti, E; Corsi, G; Guardamagna, A; Giuberti, A C; Colloi, D

    1994-04-01

    The authors report their experience with combined percutaneous nephrostomy and extracorporeal shock-wave lithotripsy to treat obstructive uratic ureteral stones. The role of nephrostomy is stressed as a diagnosis and treatment method before, during and after lithotripsy. Thus, the method proved especially useful to drain obstructed kidneys and restore peristalsis, to evacuate septic urine, to facilitate the elimination of lithiasic fragments, to perform anterograde pyelography before, during and after lithotripsy and finally to allow pharmacological litholysis. Fourteen patients were successfully treated with combined extracorporeal lithotripsy and percutaneous nephrostomy and the results compared with those obtained with other techniques--e.g., ureteroscopy, whose value appears lower because the method requires general anesthesia and is more traumatic to the ureter. The authors conclude that combined extracorporeal lithotripsy and percutaneous nephrostomy make the best technique to treat obstructive uric acid stones thanks to their positive results, low invasiveness and to patients compliance.

  7. Transuteroplacental metabolism of cortisol and cortisone during mid- and late gestation in the baboon

    Energy Technology Data Exchange (ETDEWEB)

    Pepe, G.J.; Albrecht, E.D.

    1984-11-01

    We measured uterine extraction (i.e. metabolism) and transuteroplacental interconversion of cortisol (F) and cortisone (E) to determine whether metabolism across the uterus changes during pregnancy and contributes to the MCR of these corticosteroids. On day 100 (n . 4) or 170 (n . 3) of pregnancy (term . day 184), baboons (Papio anubis; 14-18 kg) were sedated with ketamine, and a constant infusion (0.38 ml/min) of 8-12 microCi (/sup 3/H)F and 9-15 microCi (/sup 14/C)E in 80 ml 0.9% NaCl-1% ethanol was initiated (time zero) via a maternal antecubital vein. At 60 min, animals were laparotomized, and at 70, 80, and 90 min, blood samples were obtained from right and left uterine veins and from a maternal saphenous vein. At 95 min, a transverse incision was made in the uterus, the fetus was isolated, and blood samples were obtained from the umbilical vein and artery. The cord was then clamped, and the fetus was delivered. Radio-labeled F and E were extracted from serum and purified by sequential paper chromatography, and metabolic parameters were calculated. Endogenous F and E levels were determined by RIA. In the mother, the percent conversions of E to F at midgestation (mean +/- SE; 72 +/- 4) and late gestation (65 +/- 3) were similar and exceeded (P less than 0.01) respective values for oxidation of F to E (51 +/- 7 and 46 +/- 7, respectively), indicating that maternal corticosteroid metabolism favors F formation and is unchanged during the second half of gestation. In contrast, corticosteroid metabolism across the uterus and placenta (transuteroplacental) was altered during pregnancy. At midgestation, transuteroplacental conversion of E to F (37 +/- 9) exceeded (P less than 0.05) the reverse reaction (18 +/- 3), whereas oxidation of F to E at term (28 +/- 4) was 7-fold greater (P less than 0.05) than reduction of E to F (4 +/- 1).

  8. Seroprevalence of Zika Virus in Wild African Green Monkeys and Baboons

    Science.gov (United States)

    Buechler, Connor R.; Bailey, Adam L.; Weiler, Andrea M.; Barry, Gabrielle L.; Breitbach, Meghan E.; Stewart, Laurel M.; Jasinska, Anna J.; Freimer, Nelson B.; Apetrei, Cristian; Phillips-Conroy, Jane E.; Jolly, Clifford J.; Rogers, Jeffrey; Friedrich, Thomas C.

    2017-01-01

    ABSTRACT Zika virus (ZIKV) has recently spread through the Americas and has been associated with a range of health effects, including birth defects in children born to women infected during pregnancy. Although the natural reservoir of ZIKV remains poorly defined, the virus was first identified in a captive “sentinel” macaque monkey in Africa in 1947. However, the virus has not been reported in humans or nonhuman primates (NHPs) in Africa outside Gabon in over a decade. Here, we examine ZIKV infection in 239 wild baboons and African green monkeys from South Africa, the Gambia, Tanzania, and Zambia using combinations of unbiased deep sequencing, quantitative reverse transcription-PCR (qRT-PCR), and an antibody capture assay that we optimized using serum collected from captive macaque monkeys exposed to ZIKV, dengue virus, and yellow fever virus. While we did not find evidence of active ZIKV infection in wild NHPs in Africa, we found variable ZIKV seropositivity of up to 16% in some of the NHP populations sampled. We anticipate that these results and the methodology described within will help in continued efforts to determine the prevalence, natural reservoir, and transmission dynamics of ZIKV in Africa and elsewhere. IMPORTANCE Zika virus (ZIKV) is a mosquito-borne virus originally discovered in a captive monkey living in the Zika Forest of Uganda, Africa, in 1947. Recently, an outbreak in South America has shown that ZIKV infection can cause myriad health effects, including birth defects in the children of women infected during pregnancy. Here, we sought to investigate ZIKV infection in wild African primates to better understand its emergence and spread, looking for evidence of active or prior infection. Our results suggest that up to 16% of some populations of nonhuman primate were, at some point, exposed to ZIKV. We anticipate that this study will be useful for future studies that examine the spread of infections from wild animals to humans in general and

  9. Extracorporeal Membrane Oxygenation (ECMO) for Hypothermic Cardiac Deterioration: A Case Series.

    Science.gov (United States)

    Niehaus, Matthew T; Pechulis, Rita M; Wu, James K; Frei, Steven; Hong, John J; Sandhu, Rovinder S; Greenberg, Marna Rayl

    2016-10-01

    Accidental hypothermia can lead to untoward cardiac manifestations and arrest. This report presents a case series of severe accidental hypothermia with cardiac complications in three emergency patients who were treated with extracorporeal membrane oxygenation (ECMO) and survived after re-warming. The aim of this discussion was to encourage more clinicians to consider ECMO as a re-warming therapy for severe hypothermia with circulatory collapse and to prompt discussion about decreasing the barriers to its use. Niehaus MT , Pechulis RM , Wu JK , Frei S , Hong JJ , Sandhu RS , Greenberg MR . Extracorporeal membrane oxygenation (ECMO) for hypothermic cardiac deterioration: a case series. Prehosp Disaster Med. 2016;31(5):570-571.

  10. [THE BONE DEFECT HEALING UNDER THE INFLUENCE OF RADIAL EXTRACORPOREAL SHOCK-WAVE THERAPY IN EXPERIMENT].

    Science.gov (United States)

    Gertsen, G I; Se-Fey; Ostapchuk, R M; Lesovoy, A V; Zherebchuk, V V

    2016-03-01

    In experiment on 24 rabbits the processes of reparative osteogenesis in perforated defect of proximal tibial metaphysis under the influence of extracorporeal shock-wave therapy were studied. In accordance to data of clinical, roentgenological and morphological investiagations, conducted in terms 5, 15, 30 and 45 days of observation, there was established, that under the influence of extracorporeal shock-wave therapy in the bone marrow in the traumatic region a vasodilatation, as well as the blood cells exit from capillaries and sinusoid vessels with creation of massive regions of osseous endostal regenerate, guaranteeing the tibial integrity restoration, occurs.

  11. Low-Intensity Extracorporeal Shock Wave as a Novel Treatment for Erectile Dysfunction.

    Science.gov (United States)

    Pan, Michael M; Raees, Ayman; Kovac, Jason R

    2016-03-01

    The paradigm of erectile dysfunction (ED) treatment was fundamentally altered following the introduction of oral phosphodiesterase type 5 inhibitors. Unfortunately, a significant number of men exhibit a suboptimal response and require additional management strategies. One of the novel, minimally invasive strategies being developed is low-intensity extracorporeal shock wave therapy. Used in the hope of delaying placement of an inflatable penile prosthesis, the final phase of ED treatment, low-intensity extracorporeal shock wave therapy is a unique application of an established technology that may hopefully one day expand the medical options for patients with ED. This commentary will highlight the physiology underlying this technique and summarize the most recent studies.

  12. Can cellulite be treated with low-energy extracorporeal shock wave therapy?

    Science.gov (United States)

    Angehrn, Fiorenzo; Kuhn, Christoph; Voss, Axel

    2007-01-01

    The present study investigates the effects of low-energy defocused extracorporeal generated shock waves on collagen structure of cellulite afflicted skin. Cellulite measurement using high-resolution ultrasound technology was performed before and after low-energy defocused extracorporeal shock wave therapy (ESWT) in 21 female subjects. ESWT was applied onto the skin at the lateral thigh twice a week for a period of six weeks. Results provide evidence that low-energy defocused ESWT caused remodeling of the collagen within the dermis of the tested region. Improving device-parameters and therapy regimes will be essential for future development of a scientific based approach to cellulite treatment. PMID:18225463

  13. Coxa vara with proximal femoral growth arrest in patients who had neonatal extracorporeal membrane oxygenation.

    Science.gov (United States)

    DiFazio, Rachel L; Kocher, Minider S; Berven, Sigurd; Kasser, James

    2003-01-01

    This is a retrospective review of four patients in whom a pattern of coxa vara with proximal femoral growth arrest and metaphyseal irregularities developed. These patients were all treated with neonatal extracorporeal membrane oxygenation and presented with a progressive gait disturbance and pain, leg-length discrepancy, and limited abduction. Imaging revealed coxa vara with proximal femoral growth arrest. Two patients (three hips) underwent proximal femoral valgus osteotomy, one patient underwent fixation of a femoral neck fracture with subsequent greater trochanter transfer, and one patient is being observed. This case series suggests an association between neonatal extracorporeal membrane oxygenation and this unusual pattern of coxa vara with proximal femoral growth arrest.

  14. Evaluation of 6-([{sup 18}F]fluoroacetamido)-1-hexanoicanilide for PET imaging of histone deacetylase in the baboon brain

    Energy Technology Data Exchange (ETDEWEB)

    Reid, Alicia E. [National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD 20892 (United States); Medical Department, Brookhaven National Laboratory, Upton, NY 11973 (United States)], E-mail: areid@bnl.gov; Hooker, Jacob; Shumay, Elena; Logan, Jean; Shea, Colleen; Kim, Sung Won [Medical Department, Brookhaven National Laboratory, Upton, NY 11973 (United States); Collins, Shanika [School of Science, Health and Technology Medgar Evers College, Brooklyn, NY 11225 (United States); Xu Youwen [Medical Department, Brookhaven National Laboratory, Upton, NY 11973 (United States); Volkow, Nora [National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD 20892 (United States); National Institute on Drug Abuse, Bethesda, MD 20892 (United States); Fowler, Joanna S. [Medical Department, Brookhaven National Laboratory, Upton, NY 11973 (United States)

    2009-04-15

    Introduction: Histone deacetylases (HDACs) are enzymes involved in epigenetic modifications that shift the balance toward chromatin condensation and silencing of gene expression. Here, we evaluate the utility of 6-([{sup 18}F]fluoroacetamido)-1-hexanoicanilide ([{sup 18}F]FAHA) for positron emission tomography imaging of HDAC activity in the baboon brain. For this purpose, we assessed its in vivo biodistribution, sensitivity to HDAC inhibition, metabolic stability and the distribution of the putative metabolite [{sup 18}F]fluoroacetate ([{sup 18}F]FAC). Methods: [{sup 18}F]FAHA and its metabolite [{sup 18}F]FAC were prepared, and their in vivo biodistribution and pharmacokinetics were determined in baboons. [{sup 18}F]FAHA metabolism and its sensitivity to HDAC inhibition using suberanilohydroxamic acid (SAHA) were assessed in arterial plasma and by in vitro incubation studies. The chemical form of F-18 in rodent brain was assessed by ex vivo studies. Distribution volumes for [{sup 18}F]FAHA in the brain were derived. Results: [{sup 18}F]FAHA was rapidly metabolized to [{sup 18}F]FAC, and both labeled compounds entered the brain. [{sup 18}F]FAHA exhibited regional differences in brain uptake and kinetics. In contrast, [{sup 18}F]FAC showed little variation in regional brain uptake and kinetics. A kinetic analysis that takes into account the uptake of peripherally produced [{sup 18}F]FAC indicated that SAHA inhibited binding of [{sup 18}F]FAHA in the baboon brain dose-dependently. In vitro studies demonstrated SAHA-sensitive metabolism of [{sup 18}F]FAHA to [{sup 18}F]FAC within the cell and diffusion of [{sup 18}F]FAC out of the cell. All radioactivity in brain homogenate from rodents was [{sup 18}F]FAC at 7 min postinjection of [{sup 18}F]FAHA. Conclusion: The rapid metabolism of [{sup 18}F]FAHA to [{sup 18}F]FAC in the periphery complicates the quantitative analysis of HDAC in the brain. However, dose-dependent blocking studies with SAHA and kinetic modeling

  15. The effects of extracorporeal shock wave therapy on the pain and function of patients with degenerative knee arthritis.

    Science.gov (United States)

    Lee, Ji-Hyun; Lee, Sangyong; Choi, SeokJoo; Choi, Yoon-Hee; Lee, Kwansub

    2017-03-01

    [Purpose] The purpose of this study was to identify the effects of extracorporeal shock wave therapy on the pain and function of patients with degenerative knee arthritis. [Subjects and Methods] Twenty patients with degenerative knee arthritis were divided into a conservative physical therapy group (n=10) and an extracorporeal shock wave therapy group (n=10). Both groups received general conservative physical therapy, and the extracorporeal shock wave therapy was additionally treated with extracorporeal shock wave therapy after receiving conservative physical therapy. Both groups were treated three times a week over a four-week period. The visual analogue scale was used to evaluate pain in the knee joints of the subjects, and the Korean Western Ontario and McMaster Universities Osteoarthritis Index was used to evaluate the function of the subjects. [Results] The comparison of the visual analogue scale and Korean Western Ontario and McMaster Universities Osteoarthritis Index scores within each group before and after the treatment showed statistically significant declines in scores in both the conservative physical therapy group and extracorporeal shock wave therapy group. A group comparison after the treatment showed statistically significant differences in these scores in the extracorporeal shock wave therapy group and the conservative physical therapy group. [Conclusion] extracorporeal shock wave therapy may be a useful nonsurgical intervention for reducing the pain of patients with degenerative knee arthritis and improving these patients' function.

  16. The effects of extracorporeal shock wave therapy on the pain and function of patients with degenerative knee arthritis

    Science.gov (United States)

    Lee, Ji-Hyun; Lee, Sangyong; Choi, SeokJoo; Choi, Yoon-Hee; Lee, Kwansub

    2017-01-01

    [Purpose] The purpose of this study was to identify the effects of extracorporeal shock wave therapy on the pain and function of patients with degenerative knee arthritis. [Subjects and Methods] Twenty patients with degenerative knee arthritis were divided into a conservative physical therapy group (n=10) and an extracorporeal shock wave therapy group (n=10). Both groups received general conservative physical therapy, and the extracorporeal shock wave therapy was additionally treated with extracorporeal shock wave therapy after receiving conservative physical therapy. Both groups were treated three times a week over a four-week period. The visual analogue scale was used to evaluate pain in the knee joints of the subjects, and the Korean Western Ontario and McMaster Universities Osteoarthritis Index was used to evaluate the function of the subjects. [Results] The comparison of the visual analogue scale and Korean Western Ontario and McMaster Universities Osteoarthritis Index scores within each group before and after the treatment showed statistically significant declines in scores in both the conservative physical therapy group and extracorporeal shock wave therapy group. A group comparison after the treatment showed statistically significant differences in these scores in the extracorporeal shock wave therapy group and the conservative physical therapy group. [Conclusion] extracorporeal shock wave therapy may be a useful nonsurgical intervention for reducing the pain of patients with degenerative knee arthritis and improving these patients’ function. PMID:28356649

  17. Extracorporeal shock wave therapy in calcific tendinitis of the shoulder

    Energy Technology Data Exchange (ETDEWEB)

    Peters, Jutta [Bethanien Krankenhaus, Department of Radiology, Frankfurt am Main (Germany); University Hospital Frankfurt, Department of Radiology, Frankfurt am Main (Germany); Luboldt, Wolfgang; Schwarz, Wolfram; Jacobi, Volkmar; Herzog, Christopher; Vogl, Thomas J. [University Hospital Frankfurt, Department of Radiology, Frankfurt am Main (Germany)

    2004-12-01

    To investigate clinical (pain, mobility) and radiological (resolution of calcium deposits) efficacy of different energy levels of extracorporeal shock wave therapy (ESWT) in calcific tendinitis of the shoulder. There were 90 study subjects with radiographically verified calcific tendinitis of one shoulder, mean age 52{+-}6 years (range 29 - 65 years; females:males=55:35), all of whom had had symptoms for at least 6 months and substantial restriction of shoulder mobility and pain that required taking anti-inflammatory drugs. Calcium deposits were of type I or type II (clearly circumscribed and dense) and ranged from 1 cm to 3 cm in diameter. Subjects were divided into three groups to receive ESWT at one of two energy levels (E{sub 1}=0.15 mJ/mm{sup 2}, E{sub 2}=0.44 mJ/mm{sup 2}) or sham treatment. Treatment was given at 6 weekly intervals until symptoms resolved, five treatments had been given or the subject dropped out of the programme. All subjects in groups E{sub 1} and E{sub 2} completed the programme. Those in group E{sub 1} had significantly less pain during treatment but more treatments than those in group E{sub 2}, and at 6 month follow-up had residual calcification and recurrence of pain (87%). Subjects in group E{sub 2} had no residual calcification or recurrence of pain. Sham treatment had no effect. There were no side effects except a small number of haematomas (2 in E{sub 1}, 6 in E{sub 2}; maximum size 2 cm). ESWT in calcific tendinitis of the shoulder is very effective. It does not have significant side effects at an energy level of E=0.44 mJ/mm{sup 2}, which can therefore be recommended. (orig.)

  18. Gallbladder Dynamics Before and After Extracorporeal Shock Wave Lithotripsy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Myung Hea; Suk, Jae Dong; Moon, Dae Hyuk; Kim, Myung Hwan; Min, Young Il [Asian Medical Center, Ulsan University College of Medicine, Seoul (Korea, Republic of)

    1991-03-15

    Extracorporeal shock wave lithotripsy (ESWI.) with adjunctive oral litholytic therapy has proven to be a useful treatment in selected patients with gallbladder stones. To study the effect of ESWL on gallbladder dynamics, {sup 99m}Tc-DISIDA hepatobiliary scintigraphy was done for 25 patients with symptomatic gallstones and 10 normal controls. Of these 25 patients, 15 were treated with ESWL and adjunctive oral litholytic agents (ESWL group) and 10 were treated only with oral litholytic agents (UDCA group). After overnight fast and gallbladder visualization on a routine hepatobiliary scintigraphy with 7 mCi of {sup 99m}Tc-DISIDA, subjects were given fatty meal and imaged with a gamma camera interfaced to a computer (I frame/minute for 70 minutes). A gallbladder time-activity curve was generated and latent period (LP), ejection period (EP), ejection fraction (EF) and ejection rate (ER) were calculated, ESWL group were studied before, l day after and 2 weeks after ESWL, and UDCA group were studied before and 2 weeks after starting oral medication Mean basal EF was significantly reduced in patients but other parameters were not reduced. In ESlVL group, mean EF and mean ER at 1 day after ESWL were reduced. In 3 of them, gallbladder was not visualized at all. Two weeks after ESWL, however, all parameters were recovered to basal level. In UDCA group, all parameters were not changed significantly during medication. We can conclude that ESWL has such immediate adverse effect on gallbladder dynamics as reducing contractility and nonvisualization of gallbladder but it has no long-term effect.

  19. [Extracorporeal renal replacement therapies in acute renal failure].

    Science.gov (United States)

    Schaefer, R M; Barenbrock, M; Teschner, M; Bahner, U

    2000-05-15

    The most serious forms of acute renal failure (ARF) are nowadays encountered in the intensive care unit (ICU), where up to 25% of new patients are reported to develop ARF. Lethality rates may reach 50 to 90% when the ARF is part of a multiple organ dysfunction syndrome. A multitude of extracorporeal procedures have been introduced into intensive care medicine. Applied with adequate skills and experience, most of these techniques will suffice to replace excretory renal function. However, because of low efficacy arterio-venous procedures (CAVH and CAVHD) have been abandoned for the veno-venous, pump-driven techniques (CVVH and CVVHD). Up to now, there is no consensus whether continuous or intermittent renal replacement therapy is more advantageous. In many cases, oliguric patients with circulatory instability will be treated by CVVH, even though there is no prospective study to show that in terms of outcome continuous treatment is superior to intermittent hemodialysis. It is equally conceivable to treat such patients with daily, prolonged (intermittent) hemodialysis. Apparently, the dose of replacement therapy, be it continuous filtration (36 to 48 l/24 h) or intermittent hemodialysis (daily 3 to 4 h) with a target BUN of less than 50 mg/dl, is more important than the modality of treatment. Moreover, there is good evidence that the use of biocompatible membranes (no complement- or leukocyte activation) is preferable and that with high-volume hemofiltration bicarbonate-containing replacement fluids should be used. However, despite all the technical advances, we firmly believe that the skills and the experience of those physicians and nurses who actually perform renal replacement therapy in the ICU are more important than the modality of treatment applied.

  20. Logistics and safety of extracorporeal membrane oxygenation in medical retrieval.

    Science.gov (United States)

    Burns, Brian J; Habig, Karel; Reid, Cliff; Kernick, Paul; Wilkinson, Chris; Tall, Gary; Coombes, Sarah; Manning, Ron

    2011-01-01

    This article reviews the logistics and safety of extracorporeal membrane oxygenation (ECMO) medical retrieval in New South Wales, Australia. We describe the logistics involved in ECMO road and rotary-wing retrieval by a multidisciplinary team during the H1N1 influenza epidemic in winter 2009 (i.e., June 1 to August 31, 2009). Basic patient demographics and key retrieval time lines were analyzed. There were 17 patients retrieved on ECMO, with their ages ranging from 22 to 55 years. The median weight was 110 kg. Four critical events were recorded during retrieval, with no adverse outcomes. The retrieval distance varied from 20.8 to 430 km. There were delays in times from retrieval booking to both retrieval tasking and retrieval team departure in 88% of retrievals. The most common reasons cited were "patient not ready" 23.5% (4/17); "vehicle not available," 23.5% (4/17); and "complex retrieval," 41.2% (7/17). The median time (hours:minutes) from booking with the medical retrieval unit (MRU) to tasking was 4:35 (interquartile range [IQR] 3:27-6:15). The median time lag from tasking to departure was 1:00 (IQR 00:10-2:20). The median stabilization time was 1:30 (IQR 1:20-1:55). The median retrieval duration was 7:35 (IQR 5:50-10:15). The process of development of ECMO retrieval was enabled by the preexistence of a high-volume experienced medical retrieval service. Although ECMO retrieval is not a new concept, we describe an entire process for ECMO retrieval that we believe will benefit other retrieval service providers. The increased workload of ECMO retrieval during the swine flu pandemic has led to refinement in the system and process for the future.

  1. Examining Noncardiac Surgical Procedures in Patients on Extracorporeal Membrane Oxygenation.

    Science.gov (United States)

    Taghavi, Sharven; Jayarajan, Senthil N; Mangi, Abeel A; Hollenbach, Kathryn; Dauer, Elizabeth; Sjoholm, Lars O; Pathak, Abhijit; Santora, Thomas A; Goldberg, Amy J; Rappold, Joseph F

    2015-01-01

    As extracorporeal membrane oxygenation (ECMO) is increasingly used for patients with cardiac and/or pulmonary failure, the need for noncardiac surgical procedures (NCSPs) in these patients will continue to increase. This study examined the NCSP required in patients supported with ECMO and determined which variables affect outcomes. The National Inpatient Sample Database was examined for patients supported with ECMO from 2007 to 2010. There were 563 patients requiring ECMO during the study period. Of these, 269 (47.8%) required 380 NCSPs. There were 149 (39.2%) general surgical procedures, with abdominal exploration/bowel resection (18.2%) being most common. Vascular (29.5%) and thoracic procedures (23.4%) were also common. Patients requiring NCSP had longer median length of stay (15.5 vs. 9.2 days, p = 0.001), more wound infections (7.4% vs. 3.7%, p = 0.02), and more bleeding complications (27.9% vs. 17.3%, p = 0.01). The incidences of other complications and inpatient mortality (54.3% vs. 58.2%, p = 0.54) were similar. On logistic regression, the requirement of NCSPs was not associated with mortality (odds ratio [OR]: 0.91, 95% confidence interval [CI]: 0.68-1.23, p = 0.17). However, requirement of blood transfusion was associated with mortality (OR: 1.70, 95% CI: 1.06-2.74, p = 0.03). Although NCSPs in patients supported with ECMO does not increase mortality, it results in increased morbidity and longer hospital stay.

  2. Extracorporeal life support systems: alternative vs. conventional circuits.

    Science.gov (United States)

    Khan, Sameer; Vasavada, Rahul; Qiu, Feng; Kunselman, Allan; Undar, Akif

    2011-05-01

    Emerging technologies and practices for pediatric and neonatal extracorporeal life support (ECLS) are promising. This experiment sought to compare the Medtronic 0800 silicon rubber membrane oxygenator to the Quadrox-iD Pediatric oxygenator in the conventional roller pump circuit, as well as comparing the conventional circuit to an alternative circuit. Three circuits were set up in the experiment. Two conventional roller pump circuits were used to compare the two oxygenators and an alternative circuit consisting of the Quadrox-iD Pediatric oxygenator and Maquet Rotaflow centrifugal pump system was used to identify differences between circuits. All three circuits were primed with Lactated Ringers' solution and human blood, with an hematocrit of 40%. Testing occurred at flow rates of 250, 500, and 750 ml/ min at 37°C for mean arterial line pressures of 60, 80, and 100 mmHg. The results of the experiment showed lower pressure drops and greater retention of total hemodynamic energy (THE) across the Quadrox-iD Pediatric oxygenator compared to the Medtronic 0800 oxygenator. Furthermore, the centrifugal pump used in the alternative circuit showed no back flow at flow rates as low as 250 ml/min while, on the other hand, rpm levels were kept below 2200 for flow rates as high as 750 ml/min. Findings support the usage of the Quadrox-iD Pediatric oxygenator in a circuit utilizing the Maquet Rotaflow centrifugal pump system due to lower pressure drops and greater percentage of THE retained across the circuit. Additional advantages of the alternative circuit include rapid set-up time, easy transport, lower priming volumes, and no gravity-dependent venous drainage system so that it can be situated in close proximity to and at the level of the patient.

  3. Extracorporeal shockwave therapy in osteonecrosis of femoral head

    Science.gov (United States)

    Zhang, Qingyu; Liu, Lihua; Sun, Wei; Gao, Fuqiang; Cheng, Liming; Li, Zirong

    2017-01-01

    Abstract Background: Osteonecrosis is an incapacitating disorder with high morbidity. Though extracorporeal shockwave therapy (ESWT) provides a noninvasive treatment option, controversial subjects still exist about its effectiveness, indications, and mechanism of action. Methods: An electronic databases search was performed using PubMed, Embase, and the Cochrane library to collect clinical trials, case reports, and cases series on this topic and then useful data were extracted and appraised by experienced clinicians. We evaluated the quality of included evidences by using the Oxford Centre for evidence-based medicine (EBM) Levels of Evidence. Results: A total of 17 articles including 2 case reports, 9 open label trials, 2 cohorts, and 6 randomized controlled trials were considered to be eligible for this systematic review. Visual analog scale (VAS), Harris hip scores, and the imaging results were the frequently-used outcome estimates of included studies. Conclusion: By systematically analyzing these evidences, we could conclude that ESWT could act as a safe and effective method to improve the motor function and relieve the pain of patients with osteonecrosis of femoral hip, especially those at early stage. Imaging revealed that bone marrow edema was significantly relieved, but the necrotic bone could not be reversed after ESWT. This technique could slow or even block the progression of ONFH and therefore reduce the demand for surgery. Collaboration with other conservative modalities would not improve the curative benefits of ESWT. Meanwhile, ONFH with various risk factors showed similar reaction to this noninvasive treatment method. However, these conclusions should be interpreted carefully for the low-quality of included publications and further studies are requisite to validate the effect of ESWT in ONFH. PMID:28121934

  4. Steinstrasse predictive factors and outcomes after extracorporeal shockwave lithotripsy

    Directory of Open Access Journals (Sweden)

    Jarques Lucio II

    2011-08-01

    Full Text Available PURPOSE: Urinary stone disease is a common medical problem. Extracorporeal shockwave lithotripsy (SWL has been applied with high success and low complication rates. Steinstrasse (SS is a possible complication after SWL. The aim of the present study was to prospectively evaluate the factors and outcomes associated with SS after SWL. MATERIALS AND METHODS: We have prospectively evaluated 265 SWL sessions (2005-2009. Two lithotriptors were used randomly: Siemens Lithostar and Dornier Compact S. All patients had imaging exams after 30 and 90 days or according to symptoms. RESULTS: SS was observed in 14 (5.3% out of 265 SWL procedures (n = 175 patients, 51.5% women/48.5% men, mean ± SD age = 46.3 ± 15.5 years. SS was more common after SWL for pelviureteral calculi rather than caliceal stones (p = 0.036. There was a trend toward more occurrences of SS after SWL for larger stone area (> 200 mm², p = 0.072. Preoperative ureteral stent didn't prevent SS. SWL machine, intensity, number of pulses and frequency were not associated with SS formation. Post-SWL pain, fever and gravel elimination were factors associated with SS (p = 0.021; p = 0.011; p = 0.078. When SS occurred, treatment modalities included Medical Expulsive Therapy (MET, ureteroscopy and SWL. CONCLUSIONS: Steinstrasse is an uncommon event after SWL and seems to occur more frequently with larger pelviureteral stones. Impaction of stones is more frequent in the middle ureter. All patients should be followed after SWL, but SS should be specially suspected if there is macroscopic gravel elimination, flank pain and/or fever. When SS occurs, treatment should be promptly introduced, including medical expulsive therapy, surgical approach or SWL in selected cases. Further prospective studies are awaited to evaluated preventive measures for SS occurrence.

  5. 体外膜氧合用于心脏死亡后捐献供肝的初步经验%Extracorporeal Membrane Oxygenation for the Initial Experience of Donor Donated after Cardiac Death

    Institute of Scientific and Technical Information of China (English)

    李志强; 许传屾; 王淑贤; 董霏霏; 郭源; 范宁; 王建红; 吴晓东; 臧运金

    2016-01-01

    Objective Discussion extracorporeal membrane oxygenation initial experience after cardiac death donation donor used.Methods Convenient select the December 2014 to December 2015 in our hospital cardiac death donor liver tissue of 30 patients were discussed, according to the different organs of protection will be divided into study group (20 cases) and control group (10 cases), thermal control group after ischemia 30 min to be in situ cold perfusion, UV was stored liver, the study group were treated with extracorporeal membrane oxygenation techniques to hold the organ until the acquisition, and compared the two groups of liver histopathology and liver function. Results Study patients warm ischemia 30 min after his liver congestion becomes black after extracorporeal membrane oxygenation secondary recycling, slowly returned to normal liver tissue full red state, the control group of patients seen after 4h store hepatocyte edema, sinusoidal expansion. ALT and AST levels in patients with the study group were (51.5 ± 12.4) U / L and (46.0 ± 23.3) U / L, the control group of patients, respectively (76.1 ± 33.4) U / L and (150.0 ± 29.3) U / L, The difference was statistically significant (P<0.05).Conclusion Extracorporeal membrane oxygenation for liver donation after cardiac death has a protective effect, which should be widely applied.%目的:探讨体外膜氧合用于心脏死亡后捐献供肝的初步经验。方法方便选取2014年12月一2015年12月在该院心脏死亡后捐献肝脏组织的30例患者进行探讨,根据器官保护方式的不同将其分为研究组(20例)和对照组(10例),对照组热缺血30 min后予以原位冷灌注,UV液保存肝脏,研究组患者采用体外膜氧合技术保持器官直至获取,并比较两组肝脏组织病理改变以及肝功能水平。结果研究组患者热缺血30 min后其肝脏组织变为乌黑淤血,体外膜氧合辅助再循环后,肝脏组织缓慢恢复至正常饱满鲜

  6. Liver Wellness

    Science.gov (United States)

    ... can cause the liver to swell and not work well. Prevention: Hepatitis A vaccination is the best way to prevent HAV. Other ways to stop the spread of HAV are: • Always washing your hands with soap and warm water immediately after using the bathroom ...

  7. Liver Biopsy

    Science.gov (United States)

    ... and sends the sample to a lab for analysis. People with severe liver disease often have blood-clotting problems that can increase their chance of ... called collapsed lung, which occurs when air or gas builds up in the pleural space. ... of blood in the pleural space. puncture of other organs. ...

  8. Elevated Liver Enzymes

    Science.gov (United States)

    Symptoms Elevated liver enzymes By Mayo Clinic Staff Elevated liver enzymes may indicate inflammation or damage to cells in the liver. Inflamed or ... than normal amounts of certain chemicals, including liver enzymes, into the bloodstream, which can result in elevated ...

  9. Tests for Liver Cancer

    Science.gov (United States)

    ... Cancer Early Detection, Diagnosis, and Staging Tests for Liver Cancer If you have some of the signs ... Health Care Team About Liver Cancer? More In Liver Cancer About Liver Cancer Causes, Risk Factors, and ...

  10. Liver cancer - hepatocellular carcinoma

    Science.gov (United States)

    Primary liver cell carcinoma; Tumor - liver; Cancer - liver; Hepatoma ... Hepatocellular carcinoma accounts for most liver cancers. This type of cancer occurs more often in men than women. It is usually diagnosed in people age 50 or ...

  11. Liver Transplant: Nutrition

    Science.gov (United States)

    ... ZIP code here Enter ZIP code here Liver Transplant: Nutrition for Veterans and the Public Nutrition Liver ... apply to transplant and liver disease patients. Pre-Transplant Protein Malnutrition -- Many patients with end stage liver ...

  12. Liver Function Tests

    Science.gov (United States)

    ... Baby Boomers Get Tested Core Programs HE Webinar Disney 2014 5 Ways to Love Your Liver Liver ... Drive Away Liver Disease Liver Lowdown Aug 2013 Disney Marathon In The Field Healthy Foods Diet Recommendations ...

  13. A cocktail of humanized anti-pertussis toxin antibodies limits disease in murine and baboon models of whooping cough.

    Science.gov (United States)

    Nguyen, Annalee W; Wagner, Ellen K; Laber, Joshua R; Goodfield, Laura L; Smallridge, William E; Harvill, Eric T; Papin, James F; Wolf, Roman F; Padlan, Eduardo A; Bristol, Andy; Kaleko, Michael; Maynard, Jennifer A

    2015-12-01

    Despite widespread vaccination, pertussis rates are rising in industrialized countries and remain high worldwide. With no specific therapeutics to treat disease, pertussis continues to cause considerable infant morbidity and mortality. The pertussis toxin is a major contributor to disease, responsible for local and systemic effects including leukocytosis and immunosuppression. We humanized two murine monoclonal antibodies that neutralize pertussis toxin and expressed them as human immunoglobulin G1 molecules with no loss of affinity or in vitro neutralization activity. When administered prophylactically to mice as a binary cocktail, antibody treatment completely mitigated the Bordetella pertussis-induced rise in white blood cell counts and decreased bacterial colonization. When administered therapeutically to baboons, antibody-treated, but not untreated control animals, experienced a blunted rise in white blood cell counts and accelerated bacterial clearance rates. These preliminary findings support further investigation into the use of these antibodies to treat human neonatal pertussis in conjunction with antibiotics and supportive care.

  14. Baboons' hand preference resists to spatial factors for a communicative gesture but not for a simple manipulative action.

    Science.gov (United States)

    Bourjade, Marie; Meunier, Hélène; Blois-Heulin, Catherine; Vauclair, Jacques

    2013-09-01

    Olive baboons (Papio anubis) do acquire and use intentional requesting gestures in experimental contexts. Individual's hand preference for these gestures is consistent with that observed for typical communicative gestures, but not for manipulative actions. Here, we examine whether the strength of hand preference may also be a good marker of hemispheric specialization for communicative gestures, hence differing from the strength of hand preference for manipulative actions. We compared the consistency of individuals' hand preference with regard to the variation in space of either (i) a communicative partner or (ii) a food item to grasp using a controlled set-up. We report more consistent hand preference for communicative gestures than for grasping actions. Established hand preference in the midline was stronger for gesturing than for grasping and allowed to predict the consistency of hand preference across positions. We found no significant relation between the direction of hand preference and the task.

  15. Application of piecewise hierarchical linear growth modeling to the study of continuity in behavioral development of baboons (Papio hamadryas).

    Science.gov (United States)

    Hernández-Lloreda, María Victoria; Colmenares, Fernando; Martínez-Arias, Rosario

    2004-09-01

    In behavioral science, developmental discontinuities are thought to arise when the association between an outcome measure and the underlying process changes over time. Sudden changes in behavior across time are often taken to indicate that a reorganization in the outcome-process relationship may have occurred. The authors proposed in this article the use of piecewise hierarchical linear growth modeling as a statistical methodology to search for discontinuities in behavioral development and illustrated its possibilities by applying 2-piece hierarchical linear models to the study of developmental trajectories of baboon (Papio hamadryas) mothers' behavior during their infants' 1st year of life. The authors provided empirical evidence that piecewise growth modeling can be used to determine whether abrupt changes in development trajectories are tied to changes in the underlying process. ((c) 2004 APA, all rights reserved).

  16. Evidence of a Vocalic Proto-System in the Baboon (Papio papio) Suggests Pre-Hominin Speech Precursors

    Science.gov (United States)

    Boë, Louis-Jean; Berthommier, Frédéric; Legou, Thierry; Captier, Guillaume; Kemp, Caralyn; Sawallis, Thomas R.; Becker, Yannick; Rey, Arnaud; Fagot, Joël

    2017-01-01

    Language is a distinguishing characteristic of our species, and the course of its evolution is one of the hardest problems in science. It has long been generally considered that human speech requires a low larynx, and that the high larynx of nonhuman primates should preclude their producing the vowel systems universally found in human language. Examining the vocalizations through acoustic analyses, tongue anatomy, and modeling of acoustic potential, we found that baboons (Papio papio) produce sounds sharing the F1/F2 formant structure of the human [ɨ æ ɑ ɔ u] vowels, and that similarly with humans those vocalic qualities are organized as a system on two acoustic-anatomic axes. This confirms that hominoids can produce contrasting vowel qualities despite a high larynx. It suggests that spoken languages evolved from ancient articulatory skills already present in our last common ancestor with Cercopithecoidea, about 25 MYA. PMID:28076426

  17. Liver cirrhosis and fatty liver

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008075 Effect of Jiangzhi granules on expression of leptin receptor mRNA, P-JAK2 and P-STAT3 in rats with non-alcoholic fatty liver disease. MA Zansong(马赞颂), et al. Dept Gastroenterol, Instit Spleen and Stomach Dis, Longhua Hosp. Shanghai TCM Univ, Shanghai 200032.World Chin J Digestol 2007;15(32):3360-3366. Objective To study the effect of Jiangzhi granules on non-alcoholic fatty liver disease in rats, and on the expression of

  18. Hepatic tissue engineering: from transplantation to customized cell-based liver directed therapies from the laboratory.

    Science.gov (United States)

    Fiegel, Henning C; Kaufmann, Peter M; Bruns, Helge; Kluth, Dietrich; Horch, Raymund E; Vacanti, Joseph P; Kneser, Ulrich

    2008-01-01

    Today, liver transplantation is still the only curative treatment for liver failure due to end-stages liver diseases. Donor organ shortage, high cost and the need of immunosuppressive medications are still the major limitations in the field of liver transplantation. Thus, alternative innovative cell-based liver directed therapies, e.g. liver tissue engineering, are under investigation with the aim, that in future an artificial liver tissue could be created and be used for the replacement of the liver function in patients. Using cells instead of organs in this setting should permit (i) expansion of cells in an in vitro phase, (ii) genetic or immunological manipulation of cells for transplantation, (iii) tissue typing and cryopreservation in a cell bank, and (iv) the ex vivo genetic modification of patient's own cells prior re-implantation. Function and differentiation of liver cells are influenced by the three-dimensional organ architecture. The use of polymeric matrices permits the three dimensional formation of a neo-tissue and specific stimulation by adequate modification of the matrix-surface which might be essential for appropriate differentiation of transplanted cells. Additionally, culturing hepatocytes on three dimensional matrices permits culture in a flow bioreactor system with increased function and survival of the cultured cells. Based on bioreactor technology, bioartificial liver devices (BAL) are developed for extracorporeal liver support. Although BALs improved clinical and metabolic conditions, increased patient survival rates have not been proven yet. For intra-corporeal liver replacement, a concept which combines Tissue Engineering using three-dimensional, highly porous matrices with cell transplantation could be useful. In such a concept, whole liver mass transplantation, long term engraftment and function as well as correction of a metabolic defect in animal models could be achieved with a principally reversible procedure. Future studies have to

  19. Male takeovers are reproductively costly to females in hamadryas baboons: a test of the sexual coercion hypothesis.

    Directory of Open Access Journals (Sweden)

    Pablo Polo

    Full Text Available During male takeovers, in addition to fighting off the female's current mating partner, males may exhibit intense aggressive mate guarding of the newly acquired females. Recent studies indicate that coercive sexual aggression by males is an important strategy through which sexual conflict is expressed. Previous tests of the sexual coercion hypothesis in primates have focused on assessing if female mate choice is effectively reduced by male aggression, however, only one recent study has tested a critical prediction of this hypothesis, namely, that male coercion is reproductively costly to victim females. The present study uses 15 years of data on inter-birth intervals from a large multilevel colony of baboons, mostly Papio h. hamadryas, with a mating system based on harem-defence polygyny to examine if male takeovers impact the length of the abducted females' inter-birth intervals. Our analysis of 121 inter-birth intervals from 45 adult females indicates that male takeovers are reproductively costly to abducted females as they are associated with an increase in the time they take to conceive and a lengthening of the inter-birth intervals. We discuss how several factors may contribute to this reproductive cost, including male-female sexual conflict, male-male competition, and female-female competition. Our findings suggest that the male's aggressive herding is the main contributor to the abducted females' immediate reproductive cost. We argue that although some of the male's aggressive herding may be driven by male-male competition, nonetheless, it serves a coercive function as it both constrains the female's mate choice options and hampers her immediate breeding performance. This conclusion is backed up by results obtained in the only other study that has tested the same prediction and which has been carried out in a wild population of hamadryas baboons.

  20. Male takeovers are reproductively costly to females in hamadryas baboons: a test of the sexual coercion hypothesis.

    Science.gov (United States)

    Polo, Pablo; Hernández-Lloreda, Victoria; Colmenares, Fernando

    2014-01-01

    During male takeovers, in addition to fighting off the female's current mating partner, males may exhibit intense aggressive mate guarding of the newly acquired females. Recent studies indicate that coercive sexual aggression by males is an important strategy through which sexual conflict is expressed. Previous tests of the sexual coercion hypothesis in primates have focused on assessing if female mate choice is effectively reduced by male aggression, however, only one recent study has tested a critical prediction of this hypothesis, namely, that male coercion is reproductively costly to victim females. The present study uses 15 years of data on inter-birth intervals from a large multilevel colony of baboons, mostly Papio h. hamadryas, with a mating system based on harem-defence polygyny to examine if male takeovers impact the length of the abducted females' inter-birth intervals. Our analysis of 121 inter-birth intervals from 45 adult females indicates that male takeovers are reproductively costly to abducted females as they are associated with an increase in the time they take to conceive and a lengthening of the inter-birth intervals. We discuss how several factors may contribute to this reproductive cost, including male-female sexual conflict, male-male competition, and female-female competition. Our findings suggest that the male's aggressive herding is the main contributor to the abducted females' immediate reproductive cost. We argue that although some of the male's aggressive herding may be driven by male-male competition, nonetheless, it serves a coercive function as it both constrains the female's mate choice options and hampers her immediate breeding performance. This conclusion is backed up by results obtained in the only other study that has tested the same prediction and which has been carried out in a wild population of hamadryas baboons.

  1. INITIAL IN VIVO EXPERIENCE OF PIG ARTERY PATCH TRANSPLANTATION IN BABOONS USING MUTANT MHC (CIITA-DN) PIGS

    Science.gov (United States)

    Iwase, H; Ekser, B; Satyananda, V; Zhou, H; Hara, H; Bajona, P; Wijkstrom, M; Bhama, JK; Long, C; Veroux, M; Wang, Y; Dai, Y; Phelps, C; Ayares, D; Ezzelarab, MB; Cooper, DKC

    2015-01-01

    Background In the pig-to-nonimmunosuppressed baboon artery patch model, a graft from an α1,3-galactosyltransferase gene-knockout pig transgenic for human CD46 (GTKO/CD46) induces a significant adaptive immune response (elicited anti-pig antibody response, increase in T cell proliferation on MLR, cellular infiltration of the graft), which is effectively prevented by anti-CD154mAb-based therapy. Methods As anti-CD154mAb is currently not clinically applicable, we evaluated whether it could be replaced by CD28/B7 pathway blockade or by blockade of both pathways (using belatacept+anti-CD40mAb [2C10R4]). We further investigated whether a patch from a GTKO/CD46 pig with a mutant human MHC class II transactivator (CIITA-DN) gene would allow reduction in the immunosuppressive therapy administered. Results When grafts from GTKO/CD46 pigs were transplanted with blockade of both pathways, a minimal or insignificant adaptive response was documented. When a GTKO/CD46/CIITA-DN graft was transplanted, but no immunosuppressive therapy was administered, a marked adaptive response was documented. In the presence of CD28/B7 pathway blockade (abatacept or belatacept), there was a weak adaptive response that was diminished when compared with that to a GTKO/CD46 graft. Blockade of both pathways prevented an adaptive response. Conclusion Although expression of the mutant MHC CIITA-DN gene was associated with a reduced adaptive immune response when immunosuppressive therapy was inadequate, when blockade of both the CD40/CD154 and CD28/B7 pathways was present, the response even to a GTKO/CD46 graft was suppressed. This was confirmed after GTKO/CD46 heart transplantation in baboons. PMID:25687023

  2. Behavioral effects and pharmacokinetics of (±)-3,4-methylenedioxymethamphetamine (MDMA, Ecstasy) after intragastric administration to baboons.

    Science.gov (United States)

    Goodwin, Amy K; Mueller, Melanie; Shell, Courtney D; Ricaurte, George A; Ator, Nancy A

    2013-06-01

    (±)-3,4-Methylenedioxymethamphetamine (MDMA, "Ecstasy") is a popular drug of abuse. We aimed to characterize the behavioral effects of intragastric MDMA in a species closely related to humans and to relate behavioral effects to plasma MDMA and metabolite concentrations. Single doses of MDMA (0.32-7.8 mg/kg) were administered via an intragastric catheter to adult male baboons (N = 4). Effects of MDMA on food-maintained responding were assessed over a 20-hour period, whereas untrained behaviors and fine-motor coordination were characterized every 30 minutes until 3 hours postadministration. Levels of MDMA and metabolites in plasma were measured in the same animals (n = 3) after dosing on a separate occasion. MDMA decreased food-maintained responding over the 20-hour period, and systematic behavioral observations revealed increased frequency of bruxism as the dose of MDMA was increased. Drug blood level determinations showed no MDMA after the lower doses of MDMA tested (0.32-1.0 mg/kg) and modest levels after higher MDMA doses (3.2-7.8 mg/kg). High levels of 3,4-dihydroxymethamphetamine (HHMA) were detected after all doses of MDMA, suggesting extensive first-pass metabolism of MDMA in the baboon. The present results demonstrate that MDMA administered via an intragastric catheter produced behavioral effects that have also been reported in humans. Similar to humans, blood levels of MDMA after oral administration may not be predictive of the behavioral effects of MDMA. Metabolites, particularly HHMA, may play a significant role in the behavioral effects of MDMA.

  3. Characterization of very-low-density lipoproteins isolated from baboons, and fractionated using heparin-Sepharose chromatography.

    Science.gov (United States)

    Rainwater, D L; Kushwaha, R S

    1988-02-19

    Plasma very-low-density lipoproteins (VLDL) (d less than 1.006 g/ml) were purified from baboons by repeated ultracentrifugation. The weight composition of VLDL purified from these animals was 59% triacylglycerol, 17% phospholipid, 13% cholesterol plus cholesteryl esters, and 11% protein. When purified VLDL was fractionated using heparin-Sepharose chromatography, an average of 33% of the total recovered proteins were unbound in a saline solution, and 67% (range, 31 to 92%) were bound by the column, but could be eluted with 3 M NaCl. Recoveries of starting protein and the major classes of lipids in the two fractions were 70-80%. The two fractions differed in both apolipoprotein and lipid compositions. Analysis of sodium dodecyl sulfate-treated apolipoproteins using 3-21.5% acrylamide gradient gel electrophoresis indicated that both VLDL fractions contained apolipoprotein B, but only the bound fraction possessed significant amounts of apolipoprotein E. On a weight percent basis, the apolipoprotein-E-rich (bound) VLDL fraction contained significantly more cholesterol and cholesteryl esters (P less than 0.001) and less phospholipids (P less than 0.005) compared to the apolipoprotein E-poor (unbound) VLDL. Apolipoprotein-E-poor VLDL had shorter retention times than E-rich VLDL upon gel filtration chromatography, suggesting a larger size. There was no significant correlation between plasma levels of apolipoprotein-E-poor VLDL and levels of apolipoprotein B. These results demonstrate that baboons possess VLDL which can be separated into apolipoprotein-E-poor and E-rich fractions and these fractions differ in protein and lipid composition and in size.

  4. Parasitological, Hematological and Biochemical Characteristics of a Model of Hyper-microfilariaemic Loiasis (Loa loa in the Baboon (Papio anubis.

    Directory of Open Access Journals (Sweden)

    Samuel Wanji

    2015-11-01

    Full Text Available Loiasis, a filarial infection caused by Loa loa usually thought to cause relatively minor morbidity, can cause serious and often fatal reactions in patients carrying very high levels of circulating Loa loa microfilariae (mf following administration of microfilaricidal drugs. An experimental model of this condition would greatly aid the definition of the optimal management of this important clinical presentation.Fifteen baboons (Papio anubis were infected with 600 infective larvae (L3 isolated from Chrysops vector flies. Animals were observed for any clinical changes; blood samples were collected every 1-2 months for 22 months, and analysed for parasitological, hematological and biochemical profiles using standard techniques. All animals became patent but remained clinically normal throughout the study. The parasitological pre-patent period was between 4-8 months, with a majority (60% of animals becoming patent by 5 months post infection (MPI; all animals were patent by 8 MPI. Microfilarial loads increased steadily in all animals and reached a peak at 18 MPI. By 10 MPI >70% of animals had mf >8,000 mf/mL, and at 18 MPI >70% of animals had mf >30,000 mf/mL with 50% of these animals with mf >50,000 mf/mL. Absolute eosinophil, creatinine, Ca2+ and K+ levels were generally above normal values (NV. Positive associations were seen between microfilariaemia and eosinophilia, Hb, Ca2+, and gamma-GT values, whilst significant negative associations were seen between microfilariaemia and potassium, glucose and mononuclear leukocyte levels.Infection of splenectomised baboons with L. loa can induce levels of circulating microfilariae, and corresponding haematological profiles, which parallel those seen in those humans in danger of the severe post-microfilariacide clinical responses. Utilization of this experimental model could contribute to the improved management of the loiasis related adverse responses in humans.

  5. Initial in vivo experience of pig artery patch transplantation in baboons using mutant MHC (CIITA-DN) pigs.

    Science.gov (United States)

    Iwase, H; Ekser, B; Satyananda, V; Zhou, H; Hara, H; Bajona, P; Wijkstrom, M; Bhama, J K; Long, C; Veroux, M; Wang, Y; Dai, Y; Phelps, C; Ayares, D; Ezzelarab, M B; Cooper, D K C

    2015-03-01

    In the pig-to-nonimmunosuppressed baboon artery patch model, a graft from an α1,3-galactosyltransferase gene-knockout pig transgenic for human CD46 (GTKO/CD46) induces a significant adaptive immune response (elicited anti-pig antibody response, increase in T cell proliferation on MLR, cellular infiltration of the graft), which is effectively prevented by anti-CD154mAb-based therapy. As anti-CD154mAb is currently not clinically applicable, we evaluated whether it could be replaced by CD28/B7 pathway blockade or by blockade of both pathways (using belatacept + anti-CD40mAb [2C10R4]). We further investigated whether a patch from a GTKO/CD46 pig with a mutant human MHC class II transactivator (CIITA-DN) gene would allow reduction in the immunosuppressive therapy administered. When grafts from GTKO/CD46 pigs were transplanted with blockade of both pathways, a minimal or insignificant adaptive response was documented. When a GTKO/CD46/CIITA-DN graft was transplanted, but no immunosuppressive therapy was administered, a marked adaptive response was documented. In the presence of CD28/B7 pathway blockade (abatacept or belatacept), there was a weak adaptive response that was diminished when compared with that to a GTKO/CD46 graft. Blockade of both pathways prevented an adaptive response. Although expression of the mutant MHC CIITA-DN gene was associated with a reduced adaptive immune response when immunosuppressive therapy was inadequate, when blockade of both the CD40/CD154 and CD28/B7 pathways was present, the response even to a GTKO/CD46 graft was suppressed. This was confirmed after GTKO/CD46 heart transplantation in baboons. Copyright © 2015 Elsevier B.V. All rights reserved.

  6. Measurement of the ductal L-R shunt during extracorporeal membrane oxygenation in the lamb.

    NARCIS (Netherlands)

    Tanke, R.B.; Heijst, A.F.J. van; Klaessens, J.H.G.M.; Daniels, O.; Festen, C.

    2004-01-01

    OBJECTIVE: In neonates, initially a ductal shunt is often observed during veno-arterial extracorporeal membrane oxygenation (ECMO). Depending on the degree of pulmonary hypertension in these patients, the ductal shunt will be right to left (R-L), left to right (L-R), or bidirectional. A ductal L-R s

  7. Short and Long Term Studies in Neonates treated with Extracorporeal Membrane Oxygenation (ECMO)

    NARCIS (Netherlands)

    M.N. Hanekamp (Manon)

    2005-01-01

    textabstractExtracorporeal membrane oxygenation (ECMO) is a technique for providing life support in severe but potentially reversible cardiorespiratory failure. The technique oxygenates blood outside the body, obviating the need for gas exchange in the lungs and, if necessary, provides cardiovasc

  8. Triiodothyronine facilitates weaning from extracorporeal membrane oxygenation by improved mitochondrial substrate utilization

    Energy Technology Data Exchange (ETDEWEB)

    Files, Matthew D.; Kajimoto, Masaki; Priddy, Colleen M.; Ledee, Dolena R.; Xu, Chun; Des Rosiers, Christine; Isern, Nancy G.; Portman, Michael A.

    2014-03-20

    Extracorporeal membrane oxygenation (ECMO) provides a bridge to recovery after myocardial injury in infants and children, yet morbidity and mortality remain high. Weaning from the circuit requires adequate cardiac contractile function, which can be impaired by metabolic disturbances induced either by ischemia-reperfusion and / or by ECMO.

  9. The influence of ductal left-to-right shunting during extracorporeal membrane oxygenation.

    NARCIS (Netherlands)

    Tanke, R.B.; Daniëls, O.; Heyst, A. van; Lier, H.J.J. van; Festen, C.

    2002-01-01

    BACKGROUND/PURPOSE: The aim of this study was to analyze whether a ductal left-to-right (L-R) shunt will prolong extracorporeal membrane oxygenation (ECMO) in neonates with severe pulmonary hypertension. This report discusses the onset and termination of a ductal L-R shunt and its potential influenc

  10. Long-term Follow-up of Children Treated with Neonatal Extracorporeal Membrane Oxygenation: neuropsychological outcome

    NARCIS (Netherlands)

    M.J. Madderom (Marlous)

    2013-01-01

    textabstractThis thesis aims to describe the long-term neuropsychological outcome of children and adolescents treated with neonatal extracorporeal membrane oxygenation (ECMO). ECMO is a pulmonary bypass technique providing temporary life support in potentially acute reversible (cardio)respiratory fa

  11. Extracorporeal Membrane Oxygenation (ECMO): A Treatment for Neonates in Respiratory Failure.

    Science.gov (United States)

    Morris, Donna S.; Gonzalez, Lori S.; Stewart, Sharon R.; Sampers, Jackie

    2000-01-01

    A brief history is provided of extracorporeal membrane oxygenation (ECMO), a treatment option for infants that provides prolonged circulation and reoxgenation of blood outside the body to temporarily support a failing heart or lungs. The University of Kentucky ECMO program is described, along with the positive outcomes of 19 infants. (Contains…

  12. Multislice CT scans in patients on extracorporeal membrane oxygenation: Emphasis on hemodynamic changes and imaging pitfalls

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Kao Lang; Wang, Yu Feng; Chang, Yeun Chung; Huang, Shu Chien; Chen, Shyh Jye; Chang, Chin Chen [National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei (China); Tsang, Yuk Ming [Dept. of Medical Imaging, Far Eastern Memorial Hospital, New Taipei City (China)

    2014-06-15

    This pictorial review provides the principles of extracorporeal membrane oxygenation (ECMO) support and associated CT imaging features with emphasis on the hemodynamic changes and possible imaging pitfalls encountered. It is important that radiologists in ECMO centers apply well-designed imaging protocols and familiarize themselves with post-contrast CT imaging findings in patients on ECMO.

  13. Congenital diaphragmatic hernia: To repair on or off extracorporeal membrane oxygenation?

    NARCIS (Netherlands)

    R. Keijzer (Richard); D.E. Wilschut (Dorien); R.J.M. Houmes (Robert Jan); K. van de Ven (Kees); L. de Jongste-van den Hout (Lieke); I. Sluijter (Ilona); P. Rycus (Peter); N.M.A. Bax (Klaas); D. Tibboel (Dick)

    2012-01-01

    textabstractBackground: Congenital diaphragmatic hernia (CDH) can be repaired on or off extracorporeal membrane oxygenation (ECMO). In many centers, operating off ECMO is advocated to prevent bleeding complications. We aimed to compare surgery-related bleeding complications between repair on or off

  14. Pressure-Guided Positioning of Bicaval Dual-Lumen Catheters for Venovenous Extracorporeal Gas Exchange

    Science.gov (United States)

    2013-01-01

    Peterson-Carmichael S, Lin SS, Davis D, Zaas D (2011) Active rehabilitation and physical therapy during extracorporeal membrane oxygenation while...Defreyne L, Benoit DD, Decruyenaere J (2011) Epidemiology of contrast-associated acute kidney injury in ICU patients: a retrospective cohort analysis

  15. Non-intubated recovery from refractory cardiogenic shock on percutaneous VA-extracorporeal membrane oxygenation

    NARCIS (Netherlands)

    van Houte, J; Donker, D W; Wagenaar, L J; Slootweg, A P; Kirkels, J H; van Dijk, D

    2015-01-01

    We report on the use of percutaneous femoral veno-arterial extracorporeal membrane oxygenation (VA-ECMO) in a fully awake, non-intubated and spontaneously breathing patient suffering from acute, severe and refractory cardiogenic shock due to a (sub)acute anterior myocardial infarction. Intensified h

  16. Extracorporeal shock waves lithotripsy of urinary organs in patients with one kidney

    Directory of Open Access Journals (Sweden)

    Zogović Jezdimir

    2002-01-01

    Full Text Available Extracorporeal Shock Waves Lithotripsy (ESWL is a method of choice in the treatment of lithiasis. Surgical treatment is reduced to minimum, which in our case means 1-2%. Contraindications for using this method are: blood coagulation disorders, manifest tuberculosis, pregnancy, over obesity. Thanks to appropriate indications and technique which is used in an adequate way as well as to various endurological manipulations, removal of a stone by this method is safe, trauma is minimised, which is very important for patients with one kidney. During the last three years, usually in hospital conditions, 57 patients were treated in this way. Removal of a stone was performed by Extracorporeal Shock Waves Lithotripsy as mono therapy in 30 (53% patients; Extracorporeal Shock Waves Lithotripsy by using Double-J catheter in 16 (28% patients; Extracorporeal Lithotripsy with urine derivation by percutaneous nephrostome in 11 (19% patients. Endurological methods were used in 27 patients. Disintegration of stone was performed in the proper way. Full success was reached. Two patients had incrustation of ureteral catheter which had to be removed by surgery. In two other patients with inferior function of one kidney, after brief obstruction, hemodialisis was performed. Our results confirm that this method is nonaggressive, tech nically perfect for disintegration of urineorgans stone on all levels followed by small complications which are often solved by endoscopie manipulations.

  17. Rescue a drowning patient by prolonged extracorporeal membrane oxygenation support for 117 days.

    Science.gov (United States)

    Wang, Chih-Hsien; Chou, Chun-Chih; Ko, Wen-Je; Lee, Yung-Chie

    2010-07-01

    Drowning is one of the most common causes of accidental events. Here we report a drowning patient who experienced acute respiratory distress syndrome after hospitalization. Although the compliance of lung was as poor less as 5 mL/cm H2O, this patient was eventually rescued and recovered by extraprolonged extracorporeal membrane oxygenation support for 117 days.

  18. Extracorporeal shockwave therapy for patellar tendinopathy : a review of the literature

    NARCIS (Netherlands)

    van Leeuwen, M. T.; Zwerver, J.; van den Akker-Scheek, I.

    Background and purpose: Extracorporeal shockwave therapy (EWST) has become a popular treatment for patellar tendinopathy. The purpose of this review was to study the effectiveness of ESWT treatment for patellar tendinopathy; to draft guidelines for an effective treatment protocol of ESWT treatment;

  19. Congenital diaphragmatic hernia: To repair on or off extracorporeal membrane oxygenation?

    NARCIS (Netherlands)

    R. Keijzer (Richard); D.E. Wilschut (Dorien); R.J.M. Houmes (Robert Jan); K. van de Ven (Kees); L. de Jongste-van den Hout (Lieke); I. Sluijter (Ilona); P. Rycus (Peter); N.M.A. Bax (Klaas); D. Tibboel (Dick)

    2012-01-01

    textabstractBackground: Congenital diaphragmatic hernia (CDH) can be repaired on or off extracorporeal membrane oxygenation (ECMO). In many centers, operating off ECMO is advocated to prevent bleeding complications. We aimed to compare surgery-related bleeding complications between repair on or off

  20. Impact of extracorporeal blood flow rate on blood pressure, pulse rate and cardiac output during haemodialysis

    DEFF Research Database (Denmark)

    Schytz, Philip Andreas; Mace, Maria Lerche; Soja, Anne Merete Boas

    2015-01-01

    BACKGROUND: If blood pressure (BP) falls during haemodialysis (HD) [intradialytic hypotension (IDH)] a common clinical practice is to reduce the extracorporeal blood flow rate (EBFR). Consequently the efficacy of the HD (Kt/V) is reduced. However, only very limited knowledge on the effect of redu...

  1. Extracorporeal shock wave treatment of capsular fibrosis after mammary augmentation - Preliminary results.

    Science.gov (United States)

    Heine, Norbert; Prantl, Lukas; Eisenmann-Klein, Marita

    2013-12-01

    Extracorporeal shock wave therapy has undergone continuous development and has become a well-established therapy option both in urology and in orthopaedics/trauma surgery. Experimental and clinical studies have proved the effectiveness of extracorporeal shock wave therapy in the treatment of connective tissue diseases such as fibromatosis. The pathomechanism of capsular fibrosis after augmentation of the female breast with silicone implants presents a series of analogies with mechanisms that are generally recognised to be associated with fibroproliferative diseases. The starting point of the disease is the inflammatory reaction caused by the silicone and/or by the sub-clinical bacterial contamination of the implant surface and can create an inflammatory reaction and fibrosis. A total of 19 cases of capsular fibrosis in 12 patients following insertion of mammary implants were treated with extracorporeal shock wave therapy. The therapy was performed with the Duolith SD1 system manufactured by Storz Medical. Shock waves were applied with the C-Actor handpiece designed for planar shock waves. Extracorporeal shock wave therapy appears to be a non-invasive, well-tolerated and easy-to-use procedure for pain reduction and fibrotic tissue softening, especially after aesthetic breast implant augmentation.

  2. Leucocyte depletion in a drowning victim during rewarming with extracorporeal circulation may limit pulmonary oedema

    NARCIS (Netherlands)

    Vermeijden, Wytze J.; de Vries, Hans; Kieboom, Joke; Waterbolk, Tjalling

    2006-01-01

    We report two drowning victims with hypothermic circulatory arrest who were resuscitated with the use of extracorporeal circulation (ECC). The first patient developed severe post-bypass pulmonary oedema and inspired us to use a leucocyte-depletion filter in the second patient to attenuate

  3. Effectiveness of extracorporeal shock wave therapy for tennis elbow (lateral epicondylitis).

    Science.gov (United States)

    Stasinopoulos, D; Johnson, M I

    2005-03-01

    Randomised controlled trials were reviewed to evaluate the evidence of the effectiveness of extracorporeal shock wave therapy in the management of tennis elbow. Seven relevant trials were found, which had satisfactory methodology but conflicting results. Further research with well designed randomised control trials is needed to establish the absolute and relative effectiveness of this intervention for tennis elbow.

  4. High-energy focussed extracorporeal shockwave therapy reduces pain in plantar fibromatosis (Ledderhose's disease).

    Science.gov (United States)

    Knobloch, Karsten; Vogt, Peter M

    2012-10-02

    Plantar fibromatosis is a benign disease creating nodules on the medial plantar side of affected patients. While surgical removal is regarded as the therapeutic mainstay, recurrence rates and impairment of daily activities remains substantial. High-energy focussed extracorporeal shockwave therapy has been suggested to be potentially effective in plantar fibromatosis in terms of pain reduction. High-energy focussed extracorporeal shockwave therapy reduces pain in plantar fibromatosis. A total number of six patients (5 males, 58±4 years) were included with plantar fibromatosis (Ledderhose's disease) associated with pain. Three patients were operated on previously, one had concomitant Dupuytren's contracture. High-energy focussed ESWT was applied using a Storz Duolith SD1 (2000 impulses, 3 Hz, 1.24 mJ/mm²) in two sessions with 7 days between. Pain was 6±2 at baseline, 2±1 after 14 days and 1±1 after 3 months. Softening of the nodules was noted by all patients. No adverse effects were noted. High-energy focussed extracorporeal shockwave energy reduces pain in painful plantar fibromatosis (Morbus Ledderhose). Further large-scale prospective trials are warranted to elucidate the value of high-energy focussed extracorporeal shockwave therapy (ESWT) in plantar fibromatosis in terms of recurrence and efficacy.

  5. High-energy focussed extracorporeal shockwave therapy reduces pain in plantar fibromatosis (Ledderhose’s disease)

    Science.gov (United States)

    2012-01-01

    Background Plantar fibromatosis is a benign disease creating nodules on the medial plantar side of affected patients. While surgical removal is regarded as the therapeutic mainstay, recurrence rates and impairment of daily activities remains substantial. High-energy focussed extracorporeal shockwave therapy has been suggested to be potentially effective in plantar fibromatosis in terms of pain reduction. Hypothesis High-energy focussed extracorporeal shockwave therapy reduces pain in plantar fibromatosis. Findings A total number of six patients (5 males, 58±4 years) were included with plantar fibromatosis (Ledderhose’s disease) associated with pain. Three patients were operated on previously, one had concomitant Dupuytren’s contracture. High-energy focussed ESWT was applied using a Storz Duolith SD1 (2000 impulses, 3 Hz, 1.24 mJ/mm2) in two sessions with 7 days between. Pain was 6±2 at baseline, 2±1 after 14 days and 1±1 after 3 months. Softening of the nodules was noted by all patients. No adverse effects were noted. Conclusions High-energy focussed extracorporeal shockwave energy reduces pain in painful plantar fibromatosis (Morbus Ledderhose). Further large-scale prospective trials are warranted to elucidate the value of high-energy focussed extracorporeal shockwave therapy (ESWT) in plantar fibromatosis in terms of recurrence and efficacy. PMID:23031080

  6. CESAR: conventional ventilatory support vs extracorporeal membrane oxygenation for severe adult respiratory failure

    Directory of Open Access Journals (Sweden)

    Mugford Miranda

    2006-12-01

    Full Text Available Abstract Background An estimated 350 adults develop severe, but potentially reversible respiratory failure in the UK annually. Current management uses intermittent positive pressure ventilation, but barotrauma, volutrauma and oxygen toxicity can prevent lung recovery. An alternative treatment, extracorporeal membrane oxygenation, uses cardio-pulmonary bypass technology to temporarily provide gas exchange, allowing ventilator settings to be reduced. While extracorporeal membrane oxygenation is proven to result in improved outcome when compared to conventional ventilation in neonates with severe respiratory failure, there is currently no good evidence from randomised controlled trials to compare these managements for important clinical outcomes in adults, although evidence from case series is promising. Methods/Design The aim of the randomised controlled trial of Conventional ventilatory support vs extracorporeal membrane oxygenation for severe adult respiratory failure (CESAR is to assess whether, for patients with severe, but potentially reversible, respiratory failure, extracorporeal membrane oxygenation will increase the rate of survival without severe disability ('confined to bed' and 'unable to wash or dress' by six months post-randomisation, and be cost effective from the viewpoints of the NHS and society, compared to conventional ventilatory support. Following assent from a relative, adults (18–65 years with severe, but potentially reversible, respiratory failure (Murray score ≥ 3.0 or hypercapnea with pH Discussion Analysis will be based on intention to treat. A concurrent economic evaluation will also be performed to compare the costs and outcomes of both treatments.

  7. Motor performance in five-year-old extracorporeal membrane oxygenation survivors: a population-based study.

    NARCIS (Netherlands)

    Nijhuis-Van der Sanden, M.W.G.; Cammen-van Zijp, M.H. van der; Janssen, A.J.M.; Reuser, J.J.C.M.; Mazer, P.; Heyst, A.F.J. van; Gischler, S.J.; Tibboel, D.; Kollee, L.A.A.

    2009-01-01

    INTRODUCTION: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is a cardio-pulmonary bypass technique to provide life support in acute reversible cardio-respiratory failure when conventional management is not successful. Most neonates receiving ECMO suffer from meconium aspiration syndrom

  8. Motor performance in five-year-old extracorporeal membrane oxygenation survivors: A population-based study

    NARCIS (Netherlands)

    M.W.G. Nijhuis-van der Sanden (Maria); M.H.M. van der Cammen-van Zijp (Monique); A.J.W.M. Janssen (Anjo); J.J.C.M. Reuser (Jolanda); P. Mazer (Petra); A.F.J. van Heijst (Arno); S.J. Gischler (Saskia); D. Tibboel (Dick); L.A. Kollee

    2009-01-01

    textabstractIntroduction: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is a cardio-pulmonary bypass technique to provide life support in acute reversible cardio-respiratory failure when conventional management is not successful. Most neonates receiving ECMO suffer from meconium aspira

  9. Extracorporeal shockwave therapy for patellar tendinopathy : a review of the literature

    NARCIS (Netherlands)

    van Leeuwen, M. T.; Zwerver, J.; van den Akker-Scheek, I.

    2009-01-01

    Background and purpose: Extracorporeal shockwave therapy (EWST) has become a popular treatment for patellar tendinopathy. The purpose of this review was to study the effectiveness of ESWT treatment for patellar tendinopathy; to draft guidelines for an effective treatment protocol of ESWT treatment;

  10. Minimal incisions for laparoscopic radical cystectomy with extracorporeal-assisted urinary diversion

    Directory of Open Access Journals (Sweden)

    Chih-Chin Yu

    2015-06-01

    Conclusion: Our experience shows that LRC with extracorporeal-assisted urinary diversion using minimal incisions is a safe and feasible surgical technique with less blood loss. Further reports with a longer follow-up period and large number of cases are necessary to validate our findings.

  11. Sensorineural hearing loss and language development following neonatal extracorporeal membrane oxygenation

    NARCIS (Netherlands)

    D. van den Hondel (Desiree); M.J. Madderom (Marlous); A. Goedegebure (Andre); S.J. Gischler (Saskia); P. Mazer (Petra); D. Tibboel (Dick); H. IJsselstijn (Hanneke)

    2012-01-01

    textabstractOBJECTIVE: To determine the prevalence of hearing loss in school-age children who have undergone neonatal extracorporeal membrane oxygenation (ECMO) treatment and to identify any effects of hearing loss on speech- and language development. DESIGN: Prospective longitudinal follow-up stud

  12. Retrograde intrarenal stone surgery for extracorporeal shock-wave lithotripsy-resistant kidney stones

    DEFF Research Database (Denmark)

    Jung, Helene; Nørby, Bettina; Osther, Palle Jörn

    2006-01-01

    ) for extracorporeal shock-wave lithotripsy (ESWL)-resistant kidney stones. MATERIAL AND METHODS: A total of 38 consecutive patients (18 males, 20 females) participated in the study. All patients had undergone ESWL prior to RIRS without success. In all cases the stones could be reached with the endoscope. Calculi...

  13. SUCCESSFUL EXTRACORPOREAL MEMBRANE OXYGENATION SUPPORT IN A PATIENT WITH FULMINANT MYOCARDITIS

    Institute of Scientific and Technical Information of China (English)

    Yong Yuan; Jian-ting Dong; Xuan-sheng Huang; Li-ting Zhang; Bin-fei Li; Zhi-gang Zhang; Ying Han

    2006-01-01

    @@ FULMINANT myocarditis complicated with refractory cardiogenic shock carries a very high mortality(76%). Herein we report our experience in treating a 23-year-old Chinese woman with fulminant myocarditis complicated with cardiogenic shock, who was rescued by extracorporeal membrane oxygenation (ECMO).

  14. Is extracorporeal rewarming indicated in avalanche victims with unwitnessed hypothermic cardiorespiratory arrest?

    Science.gov (United States)

    Mair, Peter; Brugger, Hermann; Mair, Birgit; Moroder, Luca; Ruttmann, Elfriede

    2014-12-01

    International guidelines recommend using extracorporeal rewarming in all hypothermic avalanche victims with prolonged cardiac arrest if they have patent airways and a plasma potassium level≤12 mmol/L. The aim of this study was to evaluate outcome data to determine if available experience with extracorporeal rewarming of avalanche victims supports this recommendation. At Innsbruck Medical University Hospital, 28 patients with hypothermic cardiac arrest following an avalanche accident were resuscitated using extracorporeal circulation. Of these patients, 25 were extricated from the snow masses with no vital signs and did not survive to hospital discharge. Three patients had witnessed cardiac arrest after extrication and a core temperature of 21.7°C, 22°C, and 24.0°C, two of whom survived long-term with full neurological recovery. A search of the literature revealed only one asystolic avalanche victim with unwitnessed hypothermic cardiac arrest (core temperature 19°C) surviving long-term. All other avalanche victims in the medical literature surviving prolonged hypothermic cardiac arrest suffered witnessed arrest after extrication with a core temperature below 24°C. Our results suggest that prognosis of hypothermic avalanche victims with unwitnessed asystolic cardiac arrest and a core temperature>24°C is extremely poor. Available outcome data do not support the use of extracorporeal rewarming in these patients.

  15. Salvage Extracorporeal Membrane Oxygenation Prior to "Bridge" Transcatheter Aortic Valve Replacement.

    Science.gov (United States)

    Chiu, Peter; Fearon, William F; Raleigh, Lindsay A; Burdon, Grayson; Rao, Vidya; Boyd, Jack H; Yeung, Alan C; Miller, David Craig; Fischbein, Michael P

    2016-06-01

    We describe a patient who presented in profound cardiogenic shock due to bioprosthetic aortic valve stenosis requiring salvage Extracorporeal Membrane Oxygenation followed by a "bridge" valve-in-valve transcatheter aortic valve replacement. doi: 10.1111/jocs.12750 (J Card Surg 2016;31:403-405).

  16. Pharmacokinetics of cefotaxime and desacetylcefotaxime in infants during extracorporeal membrane oxygenation

    NARCIS (Netherlands)

    M.J. Ahsman (Maurice); E.D. Wildschut (Enno); D. Tibboel (Dick); R.A. Mathot (Ron)

    2010-01-01

    textabstractExtracorporeal membrane oxygenation (ECMO) is used to temporarily sustain cardiac and respiratory function in critically ill infants but can cause pharmacokinetic changes necessitating dose modifications. Cefotaxime (CTX) is used to prevent and treat infections during ECMO, but the curre

  17. Liver cirrhosis and fatty liver

    Institute of Scientific and Technical Information of China (English)

    1997-01-01

    970345 An experimental and clinical study on α1-adrenergic receptor of liver plasma membranes in cir-rhosis with portal hypertension. ZHANG Youcheng(张有成), et al. Dept Surg, People’s Hosp, Beijing MedUniv, Beijing, 100044 Chin J Dig 1996; 16(6): 332-335.

  18. Treatment of acute pulmonary failure with extracorporeal support: 100% survival in a pediatric population.

    Science.gov (United States)

    Ryan, D P; Doody, D P

    1992-08-01

    Since February 1990, five children, aged 10 days to 6.5 years, were treated with extracorporeal lung support at our hospital for acute, unrelenting pulmonary failure. Two had viral pneumonia: one with respiratory syncytial virus (RSV) bronchiolitis, and one with herpes simplex virus pneumonia, encephalitis, and disseminated intravascular coagulation. One presented with a febrile illness followed by a pulmonary hemorrhage. Two patients had adult respiratory distress syndrome (ARDS) complicating severe systemic illnesses, toxic epidermal necrolysis in one and cat scratch disease with encephalitis in the other. All children had diffuse parenchymal lung disease by chest x-ray. On maximum medical management all patients were developing carbon dioxide retention and progressive hypoxemia, exceeding previously established NIH study criteria for extracorporeal treatment. Three children (10 days, 2 months, 13 months) were placed on venoarterial support and two children (20 months and 6.5 years) were placed on venovenous extracorporeal support (ECCO2R). Three of the five had open lung biopsies performed, which showed findings consistent with a moderate to severe cellular phase of ARDS. No viral inclusions were found in the patient with RSV infection. One hundred percent immediate survival was achieved in this patient population. Average duration of support was 330 hours (range, 89 to 840). Following completion of extracorporeal support, all children were successfully weaned from the ventilator with an average time to extubation of 23.2 days (range, 2 to 58 days). One child died of congestive heart failure following palliative surgery for a complex noncyanotic congenital cardiac lesion 35 days after successfully weaning from extracorporeal support for an acute febrile illness and pulmonary hemorrhage.(ABSTRACT TRUNCATED AT 250 WORDS)

  19. Extracorporeal adsorption therapy: A Method to improve targeted radiation delivered by radiometal-labeled monoclonal antibodies.

    Energy Technology Data Exchange (ETDEWEB)

    Nemecek, Eneida R.; Green, Damian J.; Fisher, Darrell R.; Pagal, John M.; Lin, Yukang; Gopal, A. K.; Durack, Lawrence D.; Rajendran, Joseph G.; Wilbur, D. S.; Nilsson, Rune; Sandberg, Bengt; Press, Oliver W.

    2008-04-01

    Many investigators have demonstrated the ability to treat hematologic malignancies with radiolabeled monoclonal antibodies targeting hematopoietic antigens such as anti-CD20 and anti-CD45. [1-5] Although the remission rates achieved with radioimmunotherapy (RIT) are relatively high, many patients subsequently relapse presumably due to suboptimal delivery of enough radiation to eradicate the malignancy. The dose-response of leukemia and lymphoma to radiation has been proven. Substantial amounts of radiation can be delivered by RIT if followed by hematopoietic cell transplantation to rescue the bone marrow from myeloablation.[ref] However, the maximum dose of RIT that can be used is still limited by toxicity to normal tissues affected by nonspecific delivery of radiation. Efforts to improve RIT focus on improving the therapeutic ratios of radiation in target versus non-target tissues by removing the fraction of radioisotope that fails to bind to target tissues and circulates freely in the bloodstream perfusing non-target tissues. Our group and others have explored several alternatives for removal of unbound circulating antibody. [refs] One such method, extracorporeal adsorption therapy (ECAT) consists of removing unbound antibody by a method similar to plasmapheresis after critical circulation time and distribution of antibody into target tissues have been achieved. Preclinical studies of ECAT in murine xenograft models demonstrated significant improvement in therapeutic ratios of radioactivity. Chen and colleagues demonstrated that a 2-hour ECAT procedure could remove 40 to 70% of the radioactivity from liver, lung and spleen. [ref] Although isotope concentration in the tumor was initially unaffected, a 50% decrease was noted approximately 36 hours after the procedure. This approach was also evaluated in a limited phase I pilot study of patients with refractory B-cell lymphoma. [ref] After radiographic confirmation of tumor localization of a test dose of anti-CD20

  20. Trough Concentrations of Vancomycin in Patients Undergoing Extracorporeal Membrane Oxygenation.

    Directory of Open Access Journals (Sweden)

    So Jin Park

    Full Text Available To investigate the appropriateness of the current vancomycin dosing strategy in adult patients with extracorporeal membrane oxygenation (ECMO, between March 2013 and November 2013, patients who were treated with vancomycin while on ECMO were enrolled. Control group consisted of 60 patients on vancomycin without ECMO, stayed in medical intensive care unit during the same study period and with the same exclusion criteria. Early trough levels were obtained within the fourth dosing, and maintenance levels were measured at steady state. A total of 20 patients were included in the analysis in ECMO group. Sixteen patients received an initial intravenous dose of 1.0 g vancomycin followed by 1.0 g every 12 hours. The non-steady state trough level of vancomycin after starting administration was subtherapeutic in 19 patients (95.00% in ECMO group as compared with 40 patients (66.67% in the control group (p = 0.013. Vancomycin clearance was 1.27±0.51 mL/min/kg, vancomycin clearance/creatinine clearance ratio was 0.90 ± 0.37, and elimination rate constant was 0.12 ± 0.04 h-1. Vancomycin dosingfrequency and total daily dose were significantly increased after clinical pharmacokinetic services of the pharmacist based on calculated pharmacokinetic parameters (from 2.10 ± 0.72 to 2.90 ± 0.97 times/day, p = 0.002 and from 32.54 ± 8.43 to 42.24 ± 14.62mg/kg, p = 0.014 in ECMO group in contrast with those (from 2.11 ± 0.69 to 2.37 ± 0.86 times/day, p = 0.071 and from 33.91 ± 11.85 to 31.61 ± 17.50 mg/kg, p = 0.350 in the control group.Although the elimination rate for vancomycin was similar with population parameter of non ECMO patients, the current dosing strategy of our institution for vancomycinin our ICU was not sufficient to achieve the target trough in the initial period in most patients receiving ECMO.