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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
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Which patient, which pump? 总被引:1,自引:0,他引:1
7.
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
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A Surowiec P N Shrivastava M Astrahan Z Petrovich 《International journal of hyperthermia》1992,8(6):795-807
A muscle-stimulating material made of polyacrylamide gel (PAG) for testing various kinds of hyperthermia applicators was investigated. The permittivity and conductivity dispersion of PAG, as well as an internal wavelength and penetration depth, were in good agreement with those of actual muscle at frequencies between 500 MHz and 3 GHz. A single formula for PAG covering three ISM bands, most commonly used for hyperthermia, 433, 915 and 2450 MHz, is presented. The physical properties of the PAG phantom allow any desired form or shape to be moulded, including shapes conforming to the actual geometry of an interstitial or intracavitary applicator. Utilization of a multilayer phantom makes possible the generation of experimental three-dimensional specific absorption rate (SAR) distributions composed from several two-dimensional SAR images at different depths or radial distances from the applicator. Spatial resolution of 1 mm can be achieved. The two-dimensional SAR distributions at different depth values for commercial superficial applicator, an interstitial antenna and a new oesophageal applicator are presented. 相似文献
10.
K A Dinshaw S C Pande S K Shrivastava M A Gonsalves S H Advani R Gopal S S Shrikhande L J Desouza P Jagannath P B Desai 《Journal of surgical oncology》1992,49(1):39-44
A retrospective analysis of 328 cases of Hodgkin's Disease (HD) subjected to a staging laparotomy at the Tata Memorial Hospital, Bombay, India, from 1974 to 1986 was undertaken to assess its relevance to our setup. Eighty percent of the patients were from clinical stages (CS) I and II, 38% with lymphocyte predominance (LP), and 41% with mixed cellularity (MC) histologies. Staging laparotomy was positive in 60% cases overall, including 50% from CS IA and IIA, 68% from CS IB and IIB, and 53% and 67%, respectively, from LP and MC histologies. Splenic involvement was seen in 54% cases. Operative complications were encountered in 2% of cases and deaths in two cases only. In view of the high propensity for abdominal spread, only selected CS IA and IIA cases would merit a staging laparotomy within which, nearly 50% cases with a negative yield could be offered radical segmental irradiation alone for cure. The majority of our patients would, however, require combination therapy. 相似文献