Morphological inspection of 80 consecutive Gyro pumps after cardiopulmonary bypass

 We have been using the Gyro centrifugal pump C1E3 for cardiopulmonary bypass in anticipation of high efficiency, low hemolysis, and antithrombogenicity of this pump. However, the clinical evaluation of this pump remains to be clarified, because it has been a short time since the pump appeared in clinical situations. The aim of the present study is to inspect and analyze the Gyro pumps morphologically after clinical use. We examined 80 consecutive pumps after cardiopulmonary bypass for 186 ± 67 min with a mean flow rate of 2.52 ± 0.22 l/min/m² at a mean rotational speed of 2485 ± 81.1 rpm. Although no abnormal findings were present in 79 pumps, one pump was found to contain effusion at the connection between the impeller body and the shaft. The extudate was supposed to be blood, based upon the results of X-ray spectrometer analysis. The cause was determined to be the upward deviation of the shaft off the impeller body. Scanning electron microscopy showed scratches on a part of the bottom housing and a smooth surface of both the male and female pivots of the pump. Surface profile measurement revealed that the deformity of the female pivots was 0.14 mm (top) and 0.05 mm (bottom). These observations suggest that the floating force and vibration by the rotating impeller acted on the joint zone between the alumina ceramic shaft and the polycarbonate impeller body, resulting in dissection of the adhesive agent from the polycarbonate. Although this abnormality may be rare, the structural design still may need to be improved. Received: November 9, 2001 / Accepted: February 4, 2002     

Impedance plethysmography in the diagnosis of arterial and venous disease

The objective of this paper is to review the theoretical basis and clinical application of electrical impedance plethysmography in the noninvasive evaluation of peripheral arterial and venous disease. Theoretical, experimental and clinical studies have now demonstrated a direct relationship between electrical impedance changes and limb volume changes. Potential sources of error have also been identified. This has led to the development of clinical tests based on impedance plethysmography for the detection of peripheral arterial disease, venous insufficiency and venous outflow obstruction. Impedance plethysmography, using the method of venous occlusion, is presently the most commonly employed noninvasive method for the detection of deep venous thrombosis.     

Understanding general practice: a conceptual framework developed from case studies in the UK NHS

BACKGROUND: General practice in the UK is undergoing a period of rapid and profound change. Traditionally, research into the effects of change on general practice has tended to regard GPs as individuals or as members of a professional group. To understand the impact of change, general practices should also be considered as organisations. AIM: To use the organisational studies literature to build a conceptual framework of general practice organisations, and to test and develop this empirically using case studies of change in practice. This study used the implementation of National Service Frameworks (NSFs) and the new General Medical Services (GMS) contract as incidents of change. DESIGN OF STUDY: In-depth, qualitative case studies. The design was iterative: each case study was followed by a review of the theoretical ideas. The final conceptual framework was the result of the dynamic interplay between theory and empirical evidence. SETTING: Five general practices in England, selected using purposeful sampling. METHOD: Semi-structured interviews with all clinical and managerial personnel in each practice, participant and nonparticipant observation, and examination of documents. RESULTS: A conceptual framework was developed that can be used to understand how and why practices respond to change. This framework enabled understanding of observed reactions to the introduction of NSFs and the new GMS contract. Important factors for generating responses to change included the story that the practice members told about their practice, beliefs about what counted as legitimate work, the role played by the manager, and previous experiences of change. CONCLUSION: Viewing general practices as small organisations has generated insights into factors that influence responses to change. Change tends to occur from the bottom up and is determined by beliefs about organisational reality. The conceptual framework suggests some questions that can be asked of practices to explain this internal reality.     

The Effect of Accuracy of Perceptions of Dietary-Fat Intake on Perceived Risk and Intentions to Change

Consumption of excess fat increases risk for many health problems and diseases. In the present study, 188 undergraduate students were studied to understand self-perceptions of dietary-fat intake and the impact of those perceptions. Findings indicated that the majority of participants had inaccurate perceptions about the amount of fat in their diets. Further, compared to people who overestimated dietary-fat intake, people who underestimated fat intake had lower perceived risk of cancer, had lower intentions to change, and demonstrated less knowledge about the dietary-fat content of many foods. Findings suggest that this unrealistic underestimation of fat intake is a cognitive barrier to dietary change and people who underestimate dietary fat intake may require more intensive intervention to change their diets.     

LHRH messenger RNA in neurons in the intact and castrate male rat forebrain,studied by in situ hybridization

Summary The slow potential change (spc) accompanying spreading depression (SD) was studied in rats and in a seizure-sensitive strain of Mongolian gerbil under three different experimental paradigms, each involving the use of naloxone. Gerbils undergoing electroconvulsive shock treatment displayed SD during the post-ictal phase, which was blocked by the intraperitoneal (i.p.) administration of naloxone (20–50 mg kg^-1). Topical application of naloxone to the exposed cortex of the anaesthetized gerbil and rat blocked the spc of SD evoked by KCl. Microiontophoretic ejection of naloxone during extracellular recordings reversed cell refractoriness following the spc, demonstrated by the observation of a maintained sensitivity to iontophoretic pulses of glutamate. The results suggest a possible involvement of naloxone-sensitive processes in the mechanism responsible for cortical SD.     

Long-term ST database: A reference for the development and evaluation of automated ischaemia detectors and for the study of the dynamics of myocardial ischaemia

The long-term ST database is the result of a multinational research effort. The goal was to develop a challenging and realistic research resource for development and evaluation of automated systems to detect transient ST segment changes in electrocardiograms and for supporting basic research into the mechanisms and dynamics of transient myocardial ischaemia. Twenty-four hour ambulatory ECG records were selected from routine clinical practice settings in the USA and Europe, between 1994 and 2000, on the basic of occurrence of ischaemic and non-ischaemic ST segment changes. Human expert annotators used newly developed annotation protocols and a specially developed interactive graphic editor tool (Semia) that supported paperless editing of annotations and facilitated international co-operation via the Internet. The database contains 86 two- and three-channel 24h annotated ambulatory records from 80 patients and is stored on DVD-ROMs. The database annotation files contain ST segment annotations of transient ischaemic (1155) and heart-rate related ST episodes and annotations of non-ischaemic ST segment events related to postural changes and conduction abnormalities. The database is intended to complement the European Society of Cardiology ST-T database and the MIT-BIH and AHA arrhythmia databases. It provides a comprehensive representation of ‘real-world’ data, with numerous examples of transient ischaemic and non-ischaemic ST segment changes, arrhythmias, conduction abnormalities, axis shifts, noise and artifacts.     

Differential effects of two types of environmental novelty on activity and sleep in BALB/cJ and C57BL/6J mice

Change in the sleeping environment can produce significant alterations in sleep. To determine how these alterations may vary with the amount of change and the relative reactivity of the sleeper, we examined the influences of environmental novelty on sleep in two mouse strains that differ in behavioral anxiety. Mice [BALB/cJ (n=7) and C57BL/6J (n=8)] were implanted for recording EEG and activity via telemetry. Following baseline data collection, activity and sleep were examined over 46 h after routine cage change, after placing a simple novel object (PVC Tee) in the home cage, and after handling controls. Mice of both strains showed immediate increases in activity and decreases in rapid eye movement sleep (REM) and non-REM (NREM) after cage change and novel object. Within strain, changes in activity and sleep were greater after cage change than after novel object. Changes in activity and sleep time were significantly correlated in each strain. Compared to C57BL/6J mice, BALB/cJ mice exhibited greater and longer duration initial reductions in sleep time, and greater increases in EEG slow wave activity power after cage change and novel object, but these changes were not followed with subsequent increases in sleep time. In contrast, C57BL/6J mice showed significantly greater subsequent increases in sleep time following the initial reductions induced by both manipulations. The results suggest that initial decreases and subsequent increases in sleep time are related to putative differences in the intensity of environmental novelty (cage change>novel object) and to previously described strain differences in anxiety (BALB/cJ>C57BL/6J).     

Hepatic changes in the acute phase of streptozotocin (SZ)-induced diabetes in mice

We have reported the streptozotocin (SZ)-induced hepatic lesions in the subacute phase (4 to 12 weeks after the treatment), which are characterized by appearance of oncocytic hepatocytes, cytomegalic hepatocytes and bile duct hyperplasia. In this study, we focused on the acute phase (6 to 48 hours after the treatment) of the SZ-induced hepatic lesions of mice to clarify the onset of the hepatic alterations, especially before the induction of hyperglycemia. Livers were taken from 8-week-old Crj:CD-1 (ICR) male mice at 6,12, 24, 36 and 48 hours after the 200 mg/kg b.w. of SZ-injection. SZ-induced hyperglycemia was noted at 36 and 48 hours after the treatment, but the hepatic changes including lipid peroxidation, mitochondrial swelling, peroxisome proliferation and inhibition of hepatocyte proliferation occurred before the elevation of the serum glucose levels. The present findings indicate the direct effects of SZ on hepatocytes rather than the secondary effects of diabetes, and certain correlations between the hepatocytic changes in the acute phase and those in the subacute one. In addition, ulcer and submucosal edema of the gallbladder were observed at 36 or 48 hours after the SZ-treatment, which can be a novel finding in SZ-treated animal.     

中学生考试焦虑问题的综述研究

目的中学生由于必须面对中考、高考等与自身前途命运密切相关的重大考试．考试焦虑问题也就显得尤为突出。本文旨在探讨中学生考试焦虑的成因及其干预策略。方法采用综述研究法。结果本文将相关理论研究更为系统化．将其更加密切地纳入心理学的理论体系之中．并将理论结合中学教育实践进行探索与研究。结论只要学生掌握了这些考试焦虑的调试方法，就能很好地调整自身考试状态，预防考试过度焦虑。     

胸部体表导纳变化与胸腔中血管导纳变化的关系

目的：探讨胸部体表导纳变化与胸腔中血管导纳变化的关系。方法：根据导纳与阻抗互为倒数的关系，导出胸部体表导纳变化公式，并用模型实验证明。结果：单根血管在胸部体表引起的导纳变化与血管本身的导纳变化和基础导纳的比值成正比，与血管的长度和胸部体表两检测电极之间的基础导纳成正比，与血管到两检测电极连线的距离成反比；多根血管在胸部体表共同引起的导纳变化等于各血管单独在胸部体表产生的导纳变化的代数和，即在电导纳图测量中导纳变化遵从标量迭加原理。结论：本文结果可为心导纳图的波形重建奠定理论基础。