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1.
2.
Roberto V.P. Ribeiro Mitesh V. Badiwala Danny Ramzy Laura C. Tumiati Vivek Rao 《The Journal of thoracic and cardiovascular surgery》2019,157(2):615-625.e1
Objective
Hypertonic saline (HTS) has potent immune and vascular effects. We assessed recipient pretreatment with HTS on allograft function in a porcine model of heart transplantation and hypothesized that HTS infusion would limit endothelial and left ventricular (LV) dysfunction following transplantation.Methods
Heart transplants were performed after 6 hours of cold ischemic storage. Recipient pigs were randomized to treatment with or without HTS (7.5% NaCl) before cardiopulmonary bypass (CPB). Using a myograft apparatus, coronary artery endothelial-dependent (Edep) and -independent (Eind) relaxation was assessed. LV performance was determined using pressure-volume loop analysis. Pulmonary interleukin (IL)-2, IL-6, and tumor necrosis factor (TNF)-α expression was measured.Results
Weaning from CPB and LV performance after transplantation were improved in HTS-treated animals. Successful weaning from CPB was greater in the HTS-treated hearts (8 of 8 vs 2 of 8; P < .05). Mean LV functional recovery was improved in the HTS-treated animals, as assessed by preload recruitable stroke work (65 ± 10% vs 27 ± 10%; P < .001) and end-systolic elastance (55 ± 7% vs 37 ± 4%; P < .001). Treatment with HTS resulted in improved Edep (mean maximum elastance [Emax], 56 ± 5% vs 37 ± 7%; P < .001) and Eind (mean Emax%, 77 ± 6% vs 52 ± 4%; P < .001) vasorelaxation compared with control. Pulmonary expression of IL-2, IL-6, and TNF-α increased following transplantation, whereas HTS therapy attenuated IL production (P < .001). Transplantation increased plasma TNF-α levels and LV TNF-α expression, whereas HTS prevented this up-regulation (P < .001).Conclusions
Recipient HTS pretreatment preserves allograft vasomotor and LV function, and HTS therapy limits CPB-induced injury. HTS may be a novel recipient intervention to prevent graft dysfunction. 相似文献3.
Functional recovery, the goal of treatment, has long been overlooked in the assessment of effectiveness of pharmacological treatments. However, with the recent shift in paradigm, from syndromal–symptomatic recovery to functional recovery, there appears to be a new interest in the definition and evaluation of functional recovery. Since functional recovery lags symptomatic recovery, sometimes by months or years, the attainment of functional recovery will be determined by both efficacy and long-term compliance. Quetiapine, due to its efficacy in both mania and depression, and effect on cognition may lead to improved functioning in patients with bipolar disorder. 相似文献
4.
Pratipal Singh Vivek Vijjan Manu Gupta Deepak Dubey Aneesh Srivastava 《International journal of urology》2007,14(6):558-560
Congenital thoracic ectopic kidney is a very rare developmental anomaly and the rarest form of all ectopic kidneys. It is usually asymptomatic and discovered incidentally on routine chest radiography. Herein we reported the first case of staghorn stone in a thoracic kidney managed successfully by percutaneous nephrolithotomy. 相似文献
5.
Which patient, which pump? 总被引:1,自引:0,他引:1
6.
X-ray fluorescence analysis has been used for measurement of lead in paint for more than a decade. The early systems provided a nondestructive alternative technology to laboratory-based technologies, but were somewhat time consuming and often led to inconclusive results. The procedure required manual substrate correction, multiple measurements, operator's discretion in validating a measurement due to interfering elements and laboratory analysis of inconclusive samples. A new instrument, the RMD LPA-1 system, has been developed based on X-ray fluorescence technology that addresses all of the drawbacks to the older systems. This new system uses a carefully designed and controlled geometry and modern microprocessor technology to automatically provide a rapid quantitative measurement of lead in paint with a 95% confidence level. The improved precision and accuracy achieved with this system are due to geometric enhancements and a mathematical approach which incorporates corrections for both random and systematic errors such as matrix effects and Compton scatter. This technology has been incorporated in a hand-held X-ray fluorescence lead paint analyzer system. A key design philosophy for this system was to maintain a very narrow, task-specific focus, the system was not designed to be an all purpose XRF analyzer, rather it is optimized to meet regulatory requirements of lead paint testing in the most efficient manner. The development of the LPA-1 system is an example of what can be accomplished by listening to the needs and desires of the users, rethinking the design of an existing technique and incorporating modern microprocessor technology. 相似文献
7.
Gangrene of Meckel's diverticulum is uncommon and its pre-operative diagnosis is difficult. We report three cases with different presentations--simulating acute appendicitis, intestinal obstruction, and strangulation of the bowel. 相似文献
8.
Whole-heart cine MRI using real-time respiratory self-gating. 总被引:1,自引:0,他引:1
Sergio Uribe Vivek Muthurangu Redha Boubertakh Tobias Schaeffter Reza Razavi Derek L G Hill Michael S Hansen 《Magnetic resonance in medicine》2007,57(3):606-613
Two-dimensional (2D) breath-hold cine MRI is used to assess cardiac anatomy and function. However, this technique requires cooperation from the patient, and in some cases the scan planning is complicated. Isotropic nonangulated three-dimensional (3D) cardiac MR can overcome some of these problems because it requires minimal planning and can be reformatted in any plane. However, current methods, even those that use undersampling techniques, involve breath-holding for periods that are too long for many patients. Free-breathing respiratory gating sequences represent a possible solution for realizing 3D cine imaging. A real-time respiratory self-gating technique for whole-heart cine MRI is presented. The technique enables assessment of cardiac anatomy and function with minimum planning or patient cooperation. Nonangulated isotropic 3D data were acquired from five healthy volunteers and then reformatted into 2D clinical views. The respiratory self-gating technique is shown to improve image quality in free-breathing scanning. In addition, ventricular volumetric data obtained using the 3D approach were comparable to those acquired with the conventional multislice 2D approach. 相似文献
9.
Vivek N Ahya Alden M Doyle James D Mendez David A Lipson Jason D Christie Emily A Blumberg Alberto Pochettino Linda Nelson Roy D Bloom Robert M Kotloff 《The Journal of heart and lung transplantation》2005,24(7):932-935
Chronic rejection is the major hurdle to long-term survival after lung transplantation. Endobronchial infection with Pseudomonas aeruginosa is common in patients with chronic rejection and this may further contribute to deterioration of the allograft. Inhaled tobramycin is commonly used to treat P aeruginosa airways infection in patients with cystic fibrosis. The safety of inhaled tobramycin in transplant recipients, however, has not been established. We describe the first report of a lung transplant recipient who developed renal failure and vestibular injury after receiving inhaled tobramycin. We review the literature regarding the safety of inhaled tobramycin and discuss potential mechanisms that may promote systemic toxicity in transplant recipients. 相似文献
10.
Vivek Shrivastava Enoch Akowuah 《European journal of cardio-thoracic surgery》2005,27(1):176-7; author reply 177