Hyperaggregating effect of hydroxyethyl starch components and University of Wisconsin solution on human red blood cells: a risk of impaired graft perfusion in organ procurement?

Background: The standard preservation solution used during organ procurement and preservation of most organs is the University of Wisconsin (UW) solution. Despite its superiority over other cold storage solutions, the inclusion of hydroxyethyl starch (HES) as one of the components of the UW solution has been both advocated and denied. This study determined whether HES had any effect on red blood cell (RBC) aggregability and correlated aggregation parameters with HES molecular weight.

Non invasive mechanical ventilation in cystic fibrosis: physiological effects and monitoring.

Chronic respiratory insufficiency in cystic fibrosis (CF) is characterised by an increase in respiratory load, which leads to alveolar hypoventilation with the preservation of respiratory muscle strength. Non-invasive mechanical ventilation (NIMV) is able to improve alveolar ventilation and thus gas exchange and allow the the respiratory muscles to rest in patients with cystic fibrosis with variable severity of lung disease. These effects state the superiority of NIMV compared to oxygen therapy in CF.

Breathlessness associated with abdominal spastic contraction in a patient with C4 tetraplegia: a case report.

A tetraplegic patient with C4 cervical cord injury reported breathlessness during episodes of spastic contraction of the abdominal muscles. To determine the mechanism, we performed electrophysiologic testing of the phrenic nerves. We measured abdominal pressure, esophageal pressure, and transdiaphragmatic pressure (Pdi) during a maximal inspiratory effort (Pdi max), a maximal sniff maneuver (sniff Pdi) during resting breathing, and during the episodes of breathlessness.

The pulmonary physician in critical care * illustrative case 4: neuromusculoskeletal disorders.

The case history is presented of a patient admitted to the ICU with ventilatory insufficiency following thoracotomy for thymic resection. The role of non-invasive ventilation for weaning in patients following phrenic nerve injury is discussed.

Subcutaneous metallic mercury injection of the hand.

Poisoning by subcutaneous metallic mercury is rare and usually accidental. Although it does not carry the same risks as mercury-vapour intoxication, it may still cause destructive early and late local reactions. Two deaths resulting from subcutaneous mercury injection have been reported in the literature.

Cough augmentation with mechanical insufflation/exsufflation in patients with neuromuscular weakness.

Adults and children with neuromuscular disease exhibit weak cough and are susceptible to recurrent chest infections, a major cause of morbidity and mortality. Mechanical insufflation/exsufflation may improve cough efficacy by increasing peak cough flow. It was hypothesised that mechanical insufflation/exsufflation would produce a greater increase in peak cough flow than other modes of cough augmentation.

Perils of immunohistochemistry: variability in staining specificity of commercially available COX-2 antibodies on human colon tissue.

We assessed the immunohistochemical (IHC) staining patterns of three commercially available COX-2 antibodies in human tissues. The location of positive stain in sequential serial 4-mu sections of formalin fixed, paraffin embedded tissue differed considerably. Staining patterns ranged from diffuse cytoplasmic to occasional perinuclear staining.

Air leaks during mechanical ventilation as a cause of persistent hypercapnia in neuromuscular disorders.

Objective: This study investigated whether air leaks from the upper airway during assisted ventilatory support are associated with persistent hypercapnia (PaCO(2) >45 mmHg) in patients with neuromuscular disorders.

Setting: A rehabilitation hospital.

Patients: The study was performed in 95 neuromuscular patients; 52 were tracheostomized with a cuffless tracheostomy tube (invasive ventilation), and 43 received noninvasive ventilation.

Statin therapy interacts with cytomegalovirus seropositivity and high C-reactive protein in reducing mortality among patients with angiographically significant coronary disease.

Background: Seropositivity to cytomegalovirus (CMV) and elevated C-reactive protein (CRP) may jointly predict increased mortality rates in patients with coronary artery disease (CAD). Therapy with statins reduces lipid levels but may also have other beneficial (eg, antiinflammatory) effects. This study prospectively evaluated the effect of statins on CMV-and CRP-associated death among patients with significant, angiographically defined CAD.

Inhibitory effects of sodium salicylate and acetylsalicylic acid on UVB-induced mouse skin carcinogenesis.

We conducted an in vivo carcinogenesis experiment to determine the efficacy of topical aspirin and sodium salicylate (NAS) in preventing UVB-induced nonmelanoma skin cancer. Hairless SKH-1 mice were randomly divided into eight treatment groups. They were treated topically with either 40 or 10 micromol aspirin or NAS three times weekly before 9 kJ/m(2) UVB irradiation.

Cardiac and respiratory effects of continuous positive airway pressure and noninvasive ventilation in acute cardiac pulmonary edema.

Objective: Continuous positive airway pressure (CPAP) is considered an effective nonpharmacologic method of treating patients with severe acute cardiogenic pulmonary edema. However, we hypothesized that bilevel noninvasive positive-pressure ventilation (NPPV), which combines both inspiratory pressure support and positive expiratory pressure, would unload the respiratory muscles and improve cardiac and hemodynamic function more effectively than CPAP.

Design: Randomized crossover study.

Vision in the peafowl (Aves: Pavo cristatus).

The visual sense of the Indian blue-shouldered peafowl Pavo cristatus was investigated with respect to the spectral absorption characteristics of the retinal photoreceptors, the spectral transmittance of the ocular media and the topographic distribution of cells in the retinal ganglion cell layer. Microspectrophotometry revealed a single class of rod, four spectrally distinct types of single cone and a single class of double cone. In the case of the single cone types, which contained visual pigments with wavelengths of maximum absorbance (lambda(max)) at 424, 458, 505 and 567 nm, spectral filtering by the ocular media and the different cone oil droplets with which each visual pigment is associated gives predicted peak spectral sensitivities of 432, 477, 537 and 605 nm, respectively.

Effect of pattern and severity of respiratory muscle weakness on carbon monoxide gas transfer and lung volumes.

In clinical practice, an elevated carbon monoxide (CO) transfer coefficient (KCO) and restrictive ventilatory defect are taken as features of respiratory muscle weakness (RMW). However, the authors hypothesised that both pattern and severity of RMW effect gas transfer and lung volumes. Measurements of CO transfer and lung volumes were performed in patients with isolated diaphragm weakness (n=10), inspiratory muscle weakness (n=12), combined inspiratory and expiratory muscle weakness (n=5) and healthy controls (n=6).

Developmental changes in the cone visual pigments of black bream Acanthopagrus butcheri.

The spectral absorption characteristics of the visual pigments in the photoreceptors of the black bream Acanthopagrus butcheri Munro (Sparidae, Teleostei), were measured using microspectrophotometry. A single cohort of fish aged 5-172 days post-hatch (dph), aquarium-reared adults and wild-caught juveniles were investigated. During the larval stage and in juveniles younger than 100 dph, two classes of visual pigment were found, with wavelengths of maximum absorbance (lambda(max)) at approximately 425 nm and 535 nm.

Comparison of proportional assist ventilation and pressure support ventilation in chronic respiratory failure due to neuromuscular and chest wall deformity.

Background: The physiological and symptomatic effects of proportional assist ventilation (PAV) and pressure support ventilation (PSV) were compared in stable awake patients with neuromuscular and chest wall deformity (NMCWD).

Methods: Oxygen saturation (SaO(2)), transcutaneous carbon dioxide (TcCO(2)), minute ventilation (VE), tidal volume (VT), respiratory rate (RR), and diaphragm electromyography (EMGdi) were measured in 15 patients during both modes. Subjective effort of breathing and synchrony with the ventilator were assessed using visual analogue scales.

Retinal characteristics of the ornate dragon lizard, Ctenophorus ornatus.

The retina of a diurnal insectivorous lizard, Ctenophorus ornatus (Agamidae) was investigated using microspectrophotometry and light and electron microscopy. A prominent broad yellow band was observed that extended across the mid-retina. The yellow coloration was found to originate from both oil droplets and diffuse pigmentation within cone inner segments.

Reproducibility of twitch and sniff transdiaphragmatic pressures.

Twitch transdiaphragmatic pressure (Tw Pdi) measured with magnetic stimulation of the phrenic nerve is used to follow up patients and to assess the effect of clinical treatments on diaphragm function. However the reproducibility of Tw Pdi on different occasions has been little studied. We investigated 32 normal subjects, measuring Tw Pdi elicited by bilateral magnetic stimulation of the phrenic nerves on two to 14 occasions.

Contribution of chiral HPLC in tandem with polarimetric detection in the determination of absolute configuration by chemical interconversion method: Example in 1-(thi)oxothiazolinyl-3-(thi)oxothiazolinyl toluene atropisomer series.

We report the determination of the absolute configuration of eight stereoisomers in the series of chiral 1-(thi)oxothiazolinyl-3-(thi)oxothiazolinyl toluene atropisomers 1-3, from the known absolute configuration of one stereoisomer, determined by X-ray crystallography. The method uses the affiliation between signs of rotation of polarised light during chemical transformations which preserve the absolute configuration and also during rotation around a single pivot bond producing a compound of known configuration. The use of chiral HPLC in tandem with a chirality detector gives a decisive advantage since such correlation can be performed on a mixture of a very limited quantity of compounds, without tedious purification steps.

Central fatigue of the diaphragm and quadriceps during incremental loading.

Anecdotal observations suggest that low frequency fatigue, as judged by a fall in twitch tension, is more difficult to achieve in the diaphragm than nonrespiratory muscle but this hypothesis has not previously been directly tested. We studied 7 subjects by performing incremental repetitive contraction loading protocols of the diaphragm and quadriceps. We measured twitch transdiaphragmatic pressure (Tw Pdi) and twitch quadriceps tension (Tw Q) during both muscle contraction and relaxation phases during the run.

Changes in pulmonary mechanics with increasing disease severity in children and young adults with cystic fibrosis.

As forced expiratory volume in 1 second (FEV(1)) is a major predictor of outcome in patients with cystic fibrosis (CF), we investigated the effect of FEV(1) on pulmonary mechanics in children and young adults with CF. We measured respiratory rate; tidal volume; minute ventilation; arterial blood gases; sniff esophageal pressure; dynamic lung compliance; total pulmonary resistance; intrinsic positive end expiratory pressure; and total, elastic, and resistive work of breathing in 32 patients (FEV(1) range: 12-49% predicted). We observed correlations between FEV(1) and Pa(O(2)) (r = 0.

Effect of severe isolated unilateral and bilateral diaphragm weakness on exercise performance.

Patients with isolated diaphragm paralysis depend on recruitment of extradiaphragmatic respiratory muscles to increase ventilation, but little is known about exercise performance or the response of the inspiratory muscles to loaded breathing. By convention, unilateral diaphragm paralysis is regarded as a trivial condition whereas bilateral paralysis is considered to be potentially life-threatening. In fact, no data exist concerning exercise performance under these conditions.

Increased resting bronchial tone in normal subjects acclimatised to altitude.

Background: Normal subjects frequently experience troublesome respiratory symptoms when acclimatised to altitude. Bronchial hyperresponsiveness (BHR) and full and partial flow-volume loops were measured before and after ascent to 5000 m altitude to determine if there are changes in resting bronchial tone and BHR that might explain the symptoms.

Methods: BHR to histamine was measured using a turbine spirometer to record partial and full flow-volume curves and expressed as log dose slopes.

Trichromacy in Australian marsupials.

Vertebrate color vision is best developed in fish, reptiles, and birds with four distinct cone receptor visual pigments. These pigments, providing sensitivity from ultraviolet to infrared light, are thought to have been present in ancestral vertebrates. When placental mammals adopted nocturnality, they lost two visual pigments, reducing them to dichromacy; primates subsequently reevolved trichromacy.