Cohomogeneity one solitons for the isometric flow of -structures.

We consider the existence of cohomogeneity one solitons for the isometric flow of -structures on the following classes of torsion-free -manifolds: the Euclidean with its standard -structure, metric cylinders over Calabi-Yau 3-folds, metric cones over nearly Kähler 6-manifolds, and the Bryant-Salamon -manifolds. In all cases we establish existence of global solutions to the isometric soliton equations, and determine the asymptotic behaviour of the torsion. In particular, existence of shrinking isometric solitons on is proved, giving support to the likely existence of type I singularities for the isometric flow.

Antenatal management of at-risk pregnancies from a distance.

This study was undertaken to determine whether antenatal care can be achieved in women with at-risk pregnancies residing in rural areas with limited access to antenatal care and maternal fetal medicine (MFM) specialists. Over a period of 15 months, 156 women with high-risk pregnancies (diabetes, hypertensive disorders, suspected fetal anomalies, prior caesarean complications) from six different healthcare units had 350 visits managed by telemedicine.

Role of telephone triage in obstetrics.

Unlabelled: The telephone has become an indispensable method of communication in the practice of obstetrics. The telephone is one of the primary methods by which the patient makes her appointments and contacts her health care provider for advice, reassurance, and referrals. Current methods of telephone triage include personal at the physicians' office, telephone answering services, labor and delivery nurses, and a dedicated telephone triage system using algorithms.

Anterior mitral valve leaflet aneurysm due to infective endocarditis detected by cardiac magnetic resonance imaging.

We report a case of mitral valve aneurysm in a 30-year-old man presenting with fatigue, malaise, and fever 10 weeks after emergent aortic valve replacement for endocarditis. The transthoracic echocardiogram demonstrated perivalvular aortic regurgitation, but no abscess cavity was defined. Cardiac magnetic resonance imaging (MRI) revealed a mitral valve leaflet aneurysm.

Coil embolization of a circumflex coronary aneurysm at the time of percutaneous coronary stenting.

Coronary atherosclerotic aneurysm often occurs in association with severe atherosclerotic coronary stenosis. We describe the percutaneous catheter-based approach to coil embolization of a circumflex coronary aneurysm at the time of obtuse marginal branch coronary stent deployment.

North American multicenter experience with the On-X prosthetic heart valve.

Background And Aim Of The Study: This ongoing, longitudinal, multi-center, North American study was designed to evaluate the safety and effectiveness of the On-X valve.

Methods: The On-X valve was implanted in isolated aortic (AVR) and mitral (MVR) valve replacement patients at nine North American centers. Follow up was 98.

Twenty-five-year experience with the Björk-Shiley convexoconcave heart valve: a continuing clinical concern.

Background: The first Björk-Shiley convexoconcave (BSCC) prosthetic heart valves were implanted in 1978. The 25th anniversary provided a stimulus to summarize the research data relevant to BSCC valve fracture, patient management, and current clinical options.

Methods And Results: Published and unpublished data on the risks of BSCC valve fracture and replacement were compiled, and strategies for identifying candidates for prophylactic valve reoperation were summarized.

Serum concentrations of cefuroxime after continuous infusion in coronary bypass graft patients.

Objective: To describe the serum concentrations of continuous infusion of cefuroxime for postsurgical prophylaxis of sternal wound infection in patients undergoing coronary artery bypass graft (CABG), and to assess the incidence of sternal wound infection in this population.

Methods: This was a prospective, noncomparative trial involving 54 patients undergoing elective CABG surgery. All patients enrolled in the study received cefuroxime 1.

Giant organized pericardial hematoma producing constrictive pericarditis: a case report and review of the literature.

Massive organized pericardial hematoma secondary to blunt trauma is extremely rare. We report a case of a 69-year-old man referred with refractory ascites who was found to have a 10 x 6 x 8 cm organized pericardial hematoma with hemodynamic characteristics consistent with constrictive pericarditis. The cause was attributed to blunt chest trauma associated with a fall 3 years previously.

Skin temperature and limb blood flow as predictors of cardiac index.

Thermodilution cardiac output and cardiac index (CI) require inserting a pulmonary artery catheter, an invasive device associated with many iatrogenic complications. The purpose of this study was to establish the concurrent validity of two noninvasive measures of CI (skin temperature and limb blood flow) by determining their correlation with invasive CI. Twenty-one subjects undergoing coronary artery bypass grafting (CABG) were studied every 2 hours for 8 hours in the immediate postoperative period.

Mixed venous oxygen saturation and oxygen partial pressure as predictors of cardiac index after coronary artery bypass grafting.

Objective: To determine the relationship between the mixed venous oxygen saturation (SvO2) and the cardiac index (CI) in individuals during the first 8 hours after coronary artery bypass grafting.

Design: Descriptive with a correlational design.

Setting: Cardiac intensive care unit at a university medical center in the midwestern United States.

Diastolic mechanical properties of the left ventricle after global ischemia.

The purpose of this study was to evaluate left ventricular (LV) diastolic mechanical properties after induced global ischemia using reliable new methods. The diastolic function of nonoxygenated crystalloid solution (CC sO2) was compared with those of oxygenated crystalloid (CC cO2) and oxygenated fluorocarbon cardioplegic (FC cO2) solutions. Postischemic ventricular performance was studied in 3 equal (no.

Short-term morbidity and mortality of implantation of automatic implantable cardioverter-defibrillator.

Over the 3-year period from Jan. 1, 1986, through Dec. 31, 1988, we have implanted 101 automatic implantable cardioverter-defibrillators into patients with life-threatening ventricular arrhythmias.

Myocardial preservation: a comparison of oxygenated crystalloid and blood cardioplegia.

The purpose of this experiment was to compare myocardial protective effect after global ischemia using oxygenated crystalloid (CCcO2) and an oxygenated blood (BCcO2) cardioplegic solutions. Post-ischemic ventricular performance was studied in 2 equal (n = 7) groups of dogs subjected to 120 min of global ischemia induced at average myocardial temperatures of 8 degrees C in the CCcO2 group and 18 degrees C in the BCcO2 group. Left ventricular (LV) function included analysis of LV systolic function (global and regional function), LV diastolic function (chamber and myocardial stiffness) and LV relaxation was measured by sonomicrometry and Millar micrometers.

Transvenous defibrillation in humans via the coronary sinus.

A consistently effective transvenous defibrillation system for use in automatic defibrillators could significantly alter the approach to patients at risk of sudden death. Transvenous defibrillation systems that use a right ventricular (RV) electrode only or an RV electrode in combination with a chest patch are relatively inefficient at applying current to the posterolateral left ventricle. An RV electrode combined with a coronary sinus (CS) electrode, however, may improve current distribution to the posterolateral left ventricle.

Comparative anatomy and histochemistry of human and canine latissimus dorsi muscle.

Gross and histologic studies of human and canine latissimus dorsi muscle were carried out to identify anatomic and histochemical properties that may be relevant to its use as a resource muscle, particularly for heart reconstruction. In both human and canine latissimus dorsi, three distinct muscle segments were observed, differing in direction of fibers, fiber characteristics, thickness, and blood supply. The entire canine latissimus dorsi could also be separated into superficial and deep layers, whereas only the anterolateral segment of human latissimus dorsi was separated further by the neurovascular bundle.

Neurobehavioral outcomes in cardiac operations. A prospective controlled study.

To assess the severity and duration of new organic brain dysfunction after cardiac operations, we used an extensive battery of neuropsychologic tests to evaluate 65 patients undergoing coronary artery bypass grafting and 25 patients undergoing intracardiac operations with cardiopulmonary bypass. Patients were tested the day before the operation, before discharge from the hospital, and approximately 7 months later. Compared to 47 nonsurgical control subjects tested at comparable time intervals, surgical subjects showed generalized impairment of neuropsychologic abilities near the time of discharge from the hospital.

Effect of voltage and charge of electrical ablation pulses on canine myocardium.

Multiple paired lesions produced by a train of high-voltage low-charge rectangular pulses (20 A, 30 microsecond) and a train of low-voltage high-charge rectangular pulses (2 A, 300 microsecond) were made to the left ventricular epicardium of 23 dogs to determine the relative influence of voltage and charge delivery on injury of canine myocardium. Both pulsing methods contained equal amounts of energy (15 J) delivered over equal periods of time (100 ms), and both pulsing methods were nonarcing and therefore nonbarotraumatic. The volume of cardiac tissue injury resulting from both types of pulses was then evaluated from planimetered serial histological sections after 1, 10, and 30 days.

A prospective randomized evaluation of biphasic versus monophasic waveform pulses on defibrillation efficacy in humans.

Biphasic waveforms have been suggested as a superior waveform for ventricular defibrillation. To test this premise, a prospective randomized intraoperative evaluation of defibrillation efficacy of monophasic and biphasic waveform pulses was performed in 22 survivors of out of hospital ventricular fibrillation who were undergoing cardiac surgery for implantation of an automatic defibrillator. The initial waveform used in a patient for defibrillation testing, either monophasic or biphasic, was randomly selected.

Direct surgical treatment of atrioventricular node reentrant tachycardia.

Atrioventricular node reentry tachycardia is a common type of supraventricular tachycardia. Rarely is it incapacitating and refractory to drug therapy, but when it is, the only option in therapy until recently has been atrioventricular node ablation or antitachycardia pacemaker insertion. The purpose of this paper is to review the case histories of four patients in whom we have surgically abolished atrioventricular node reentrant tachycardia while intentionally preserving atrioventricular node conduction.