Closed-loop regulation of arterial pressure after acute brain death

The purpose of this concept study was to investigate the possibility of automatic mean arterial pressure (MAP) regulation in a porcine heart-beating brain death (BD) model. Hemodynamic stability of BD donors is necessary for maintaining acceptable quality of donated organs for transplantation. Manual stabilization is challenging, due to the lack of vasomotor function in BD donors. Closed-loop stabilization therefore has the potential of increasing availability of acceptable donor organs, and serves to indicate feasibility within less demanding patient groups. A dynamic model of nitroglycerine pharmacology, suitable for controller synthesis, was identified from an experiment involving an anesthetized pig, using a gradient-based output error method. The model was used to synthesize a robust PID controller for hypertension prevention, evaluated in a second experiment, on a second, brain dead, pig. Hypotension was simultaneously prevented using closed-loop controlled infusion of noradrenaline, by means of a previously published controller. A linear model of low order, with variable (uncertain) gain, was sufficient to describe the dynamics to be controlled. The robustly tuned PID controller utilized in the second experiment kept the MAP within a user-defined range. The system was able to prevent hypertension, exceeding a reference of 100 mmHg by more than 10%, during 98% of a 12 h experiment. This early work demonstrates feasibility of the investigated modelling and control synthesis approach, for the purpose of maintaining normotension in a porcine BD model. There remains a need to characterize individual variability, in order to ensure robust performance over the expected population.     

Value of adipokines in predicting the severity of acute pancreatitis: Comprehensive review

AIM: To analyze the prognostic value of adipokines in predicting the course, complications and fatal outcome of acute pancreatitis (AP).METHODS: We performed the search of PubMed database and the systemic analysis of the literature for both experimental and human studies on prognostic value of adipokines in AP for period 2002-2012. Only the papers that described the use of adipokines for prediction of severity and/or complications of AP were selected for further analysis. Each article had to contain information about the levels of measured adipokines, diagnosis and verification of AP, to specify presence of pancreatic necrosis, organ dysfunction and/or mortality rates. From the very beginning, study was carried out adhering to the PRISMA checklist and flowchart for systemic reviews. To assess quality of all included human studies, the Quality Assessment of Diagnostic Accuracy Studies tool was used. Because of the high heterogeneity between the studies, it was decided to refrain from the statistical processing or meta-analysis of the available data.RESULTS: Nine human and three experimental studies were included into review. In experimental studies significant differences between leptin concentrations at 24 and 48 h in control, acute edematous and acute necrotizing pancreatitis groups were found (P = 0.027 and P < 0.001). In human studies significant differences between leptin and resitin concentrations in control and acute pancreatitis groups were found. 1-3 d serum adiponectin threshold of 4.5 μg/mL correctly classified the severity of 81% of patients with AP. This threshold yielded a sensitivity of 70%, specificity 85%, positive predictive value 64%, negative predictive value88% (area under curve 0.75). Resistin and visfatin concentrations differ significantly between mild and severe acute pancreatitis groups, they correlate with severity of disease, need for interventions and outcome. Both adipokines are good markers for parapancreatic necrosis and the cut-off values of 11.9 ng/mL and 1.8 ng/mL respectively predict the high ranges of radiological scores. However, the review revealed that all nine human studies with adipokines are very different in terms of methodology and objectives, so it is difficult to generalize their results. It seems that concentrations of the leptin and resistin increases significantly in patients with acute pancreatitis compared with controls. Serum levels of adiponectin, visfatin and especially resitin (positive correlation with Acute Physiology and Chronic Health Evaluation II, Ranson and C-reactive protein) are significantly different in mild acute pancreatitis and severe acute pancreatitis patients, so, they can serve as a markers for the disease severity prediction. Resistin and visfatin can also be used for pancreatic and parapancreatic necrosis prediction, interventions needs and possible, outcome.CONCLUSION: High levels of adipokines could allow for prediction of a severe disease course and outcome even in small pancreatic lesions on computed tomography scans.     

Kinetics of Antibacterial Activity and Physicochemical Damage Caused by the Extracts of Senna alata Flowers

A partially purified extract of Senna alata flower exhibited appreciable antibacterial activity against Staphylococcus aureus, Bacillus subtilis, Micrococcus luteus, and Pseudomonas putida. The rate at which Gram positive bacteria were killed by the plant extract was high for the first 30 min, but decreased substantially thereafter. The effect of the extract was roughly proportional to the concentration. The mechanism of antibacterial activity of the Senna alata plant extract involved potassium ion and protein leakage. While maximum potassium leakage occurred within 30 min, protein efflux was at a peak after 75 min. Microscopic examination suggested that Bacillus subtilis cells were mummified while Staphylococcus aureus cells were lysed.     

Selective staining of a subset of Purkinje cells in the human cerebellum with monoclonal antibody mabQ113

MabQ113 is a monoclonal antibody raised against rat cerebellum which selectively stains Purkinje cells. Likewise, in mabQ113-immunoperoxidase stained sections of human cerebellum, deposits of reaction product are found only in the Purkinje cells. The dendritic arborizations, cell body, and axonal processes are immunoreactive. In rat, mabQ113 reveals a series of parasagittal antigenic bands which run throughout the cerebellar cortex. The staining distribution in human cerebellar cortex likewise reveals heterogenous staining but the pattern is a complex one and seems to be unlike the parasagittal banding found in the rat. In a number of human diseases Purkinje cell degeneration is not uniform throughout the vermis and cerebellar hemispheres. It is possible that mabQ113⁺ and mabQ113− subsets of Purkinje cells may respond differentially to various pathological conditions.     

Concrete Modular Pavement Structures with Optimized Thickness Based on Characteristics of High Performance Concrete Mixtures with Fibers and Silica Fume

Usually, C30/37 strength class concrete is used to construct concrete pavements on a rigid, semi-rigid or flexible base. Concrete with such a strength delivers essential design characteristics: flexural strength and tensile splitting strength are between 4.5–5.4 MPa and 2.8–3.7 MPa, respectively. Design characteristics can be significantly increased by densifying the concrete mixture, i.e., adding silica fume, steel or polypropylene macro fibers. As high-performance concrete characteristics are 20–60% higher than those for standard concrete (C30/37), new possibilities to reduce the thickness of concrete pavement slabs appear. The theoretical analysis of concrete pavement structures with high-performance concrete mixtures (C40/50, C45/55 and C50/60) showed that slab thickness could be reduced by 6–39% compared to a standard concrete pavement structure depending on the concrete properties and design method. From all those pavement structures, three concrete mixtures were determined as the most rational ones in terms of PCP thickness reduction and total pavement cost: (i) with 49.5 kg/m³ of steel fibers and 25.2 kg/m³ of silica fume; (ii) with 10.0 kg/m³ of polypropylene fibers (type A); (iii) with 49.5 kg/m³ of steel fibers.