Oxygen-enriched photoconversion of fluorescent dyes by means of a closed conversion chamber.

The goal of the present study was an improvement of the widely used photoconversion technique, which still represents the major approach to the ultrastructural analysis of tissue labelled with fluorescent dyes. Since free access of oxygen to the tissue is essential for the dye-dependent photooxidation of diaminobenzidine (DAB), we attempted to facilitate the process using a closed conversion chamber (CCC), which allows photoconversion in an atmosphere of pure oxygen. Fixed rat tissue samples, containing 4Di-10ASP labelled retinal ganglion cells and Cy3 stained cortical perineuronal nets, were choosen to test the applicability and efficiency of the proposed system.

Intraoperative autologous transfusion during elective infrarenal aortic reconstruction.

Intraoperative autologous transfusion devices have been purported to reduce allogenic transfusions and their associated complications. However, the value of their routine use during elective cardiovascular operations remains undefined. This study was designed to examine the efficacy of the Haemonetics Cell Saver (CS) during elective aortic reconstructions and identify predictors of clinically significant (> or = 500 cc) and cost-efficient (> or = 1250 cc) salvage volumes.

Analysis of a survey of UHC hospitals--College of Pharmacy relationships.

The University HealthSystem Consortium (UHC) Pharmacy Advisory Council commissioned a survey of the methods and resources used to support pharmacy practice education. This article presents the results of the two-part survey, and presents a brief description and analysis of the results. Fifty-two of the UHC's member hospitals' pharmacies replied to the survey.

Visceral ischemia-reperfusion injury promotes tumor necrosis factor (TNF) and interleukin-1 (IL-1) dependent organ injury in the mouse.

Acute visceral ischemia and subsequent reperfusion injury, which accompanies the surgical repair of a thoracoabdominal aorta aneurysm, is associated with high rates of morbidity and mortality. The purpose of the present study was to determine whether endogenous tumor necrosis factor-alpha (TNF-alpha) and interleukin-1 (IL-1) production contributes to organ dysfunction in animals subjected to visceral ischemia secondary to 30 min of supraceliac aortic occlusion. C57BL6/j mice were treated with either a TNF binding protein (TNF-bp-10 mg/kg) or an anti-IL-1 receptor type 1 antibody (150 micrograms) 2 h prior to 30 min of supraceliac aortic occlusion.

Visceral ischemia and organ dysfunction after thoracoabdominal aortic aneurysm repair. A clinical and cost analysis.

Objective: Repair of thoracoabdominal aortic aneurysms (TAAAs) is associated with significant postoperative morbidity and mortality. Reperfusion of acutely ischemic abdominal viscera in animals leads to release of multiple factors that cause local and distant organ damage, and similar phenomena occurring in humans after TAAA repair could contribute to the high morbidity/mortality and cost associated with this procedure.

Methods: Twenty-nine patients undergoing elective TAAA repair were studied prospectively.

Extracellular matrix organization in various regions of rat brain grey matter.

Previous studies revealed the concentration of extracellular matrix proteoglycans in the so-called perineuronal nets on the one hand and in certain zones of the neuropil on the other. This nonhomogeneous distribution suggested a non-random chemical and spatial heterogeneity of the extracellular space. In the present investigation, regions dominated by one of both distribution patterns, i.

Increased soluble interleukin-1 type II receptor concentrations in postoperative patients and in patients with sepsis syndrome.

Plasma interleukin-1 (IL-1) activity is modulated in part through the simultaneous appearance of several inhibitors of IL-1 action, including interleukin-1 receptor antagonist (IL-1ra) and the soluble IL-1 type II receptor (IL-1RII). However, little is known concerning the plasma appearance of these inhibitors in patients following operative trauma or those with sepsis syndrome. In the present report, plasma IL-1beta, IL-1ra, and soluble IL-1RI and IL-1RII concentrations were evaluated in 118 patients with sepsis syndrome or after elective operative trauma.

Peripheral artery recanalization in humans using balloon and laser angioplasty.

The treatment of patients with complex peripheral arterial disease and those who have had previous unsuccessful attempted revascularization procedures can be clinically challenging. Initial treatment was begun using therapy by percutaneous balloon and laser angioplasty, then proceeding to bypass surgery if severe ischemia persisted. Both percutaneous and cut-down approaches were used to access totally occluded arteries.

Estimating the rate of adverse drug reactions with capture-recapture analysis.

The capture-recapture technique used to estimate the number of ADRs at UICMC may offer institutions and health systems a way to better identify and address the occurrence of ADRs.

Limited thrombogenicity of low temperature, laser-welded vascular anastomoses.

Background And Objective: Laser welding of vascular anastomoses has been shown to be feasible, but the clinically relevant advantages of this technique remain to be demonstrated.

Study Design/materials And Methods: To determine whether laser welding decreases initial anastomotic thrombogenicity, argon laser-welded aortic and venacaval anastomoses were constructed in 15 New Zealand white rabbits. Low temperature welding was done in one-half of welded anastomoses using low power ( < 0.

Control charts to monitor rates of adverse drug reactions.

We describe the use of control charts in monitoring rates of adverse drug reactions. Adverse drug reactions are recognized as important outcomes of patient care and are specifically associated with the process of medication use. The systematic monitoring of adverse drug reactions may allow one to identify opportunities to improve this process.

Phase II trial of 5-fluorouracil, folinic acid, and N,N1,N11-triethylenethiophosphoramide (thiotepa) in patients with advanced breast cancer.

A total of 35 women with advanced, metastatic breast cancer were treated with combination chemotherapy consisting of folinic acid 500 mg/m2 over 2 hours administered with 600 mg/m2 of 5FU at the midpoint of the folinic acid infusion weekly for 6 weeks, plus 60 mg/m2 of thiotepa on day 1 and day 28. The cycle was repeated every 8 weeks. Patients were evaluated for toxicity weekly.

Hydrophilic surface modification of metallic endoluminal stents.

Purpose: Stainless steel endovascular stents are inherently thrombogenic so that thrombus accumulates on these devices, leading to acute vessel occlusion. A potential solution to this problem is stent surface modification with hydrophilic polymers, which might limit platelet adhesion and reactivity.

Methods: N-vinylpyrrolidone (NVP) and potassium sulfopropyl acrylate (KSPA) hydrophilic monomers were gamma graft polymerized onto 1 cm2 stainless steel slabs and 4 mm Palmaz stainless steel stents.

Operative mortality rates after elective infrarenal aortic reconstructions.

Purpose: This study was designed to test the hypothesis that cardiac complications (myocardial infarction, congestive heart failure, fatal arrhythmias) are no longer the leading cause of death after elective aortic reconstructions.

Methods: The medical records of all elective infrarenal aortic reconstructions performed between January 1982 and June 1994 were retrospectively reviewed. All perioperative deaths were analyzed to determine the cause of death and were compared with a subset of 266 survivors to identify any associated preoperative or intraoperative factors.

Selection of patients for renal artery repair using captopril testing.

Background: Prediction of improvement following surgical or radiologic intervention in patients thought to have renovascular hypertension (RVH) is often unreliable. Use of the angiotensin-converting enzyme inhibitor captopril in conjunction with measurement of peripheral renin levels or radioisotope renograms is thought to detect patients with functionally significant renal artery stenosis. However, it is unclear whether these tests can identify patients whose hypertension will significantly improve after renal artery repair.

Directional coronary atherectomy for the diagnosis and treatment of radiation-induced coronary artery stenosis.

While radiation therapy has been known to cause myocardial and pericardial damage, its role in accentuating coronary artery disease in the absence of traditional cardiovascular risk factors has been controversial. As younger patients with treatable cancers are being treated with mediastinal radiation, coronary artery disease as a cause for severe chest pain should be entertained as a possible diagnosis. We describe a 25-year-old male who presented with an inferior wall myocardial infarction 6 years after receiving mediastinal radiation and chemotherapy for Hodgkin's disease.

Limb-threatening ischemia due to multilevel arterial occlusive disease. Simultaneous or staged inflow/outflow revascularization.

Summary Background Data: Limb-threatening ischemia due to severe multilevel arterial occlusive disease may require both inflow and outflow bypass to achieve limb salvage. Simultaneous inflow/outflow bypass has been advocated because the cumulative risks of separate staged inflow/outflow procedures can be avoided. However, the magnitude of complete revascularization is substantial; thus, the morbidity and mortality of simultaneous inflow/outflow bypass may be excessive.

The relationship between carotid plaque composition, plaque morphology, and neurologic symptoms.

Variations in plaque composition could make carotid artery plaques prone to ulceration, subintimal hemorrhage, plaque progression, or embolization and, thus, increase the risk of ipsilateral ischemic neurologic events. Seventy-eight carotid endarterectomy specimens from 74 patients (38 symptomatic and 36 asymptomatic) were analyzed. Prior to analysis, 43 of the 78 plaques were divided into sections based on disease severity and examined by light microscopy for surface ulceration and subintimal hemorrhage.

Impact of angioscopy on infrainguinal graft patency.

To investigate the impact of angioscopy on infrainguinal graft patency, 50 consecutive cases with angioscopy as an adjuvant to infrainguinal arterial bypass performed during a 12-month period were reviewed (group I). For comparison, 42 similar cases of infrainguinal arterial reconstruction performed during the 12 months prior to introduction of routine intraoperative angioscopy were also reviewed (group II). Patients were followed up for 12 months and graft patency was determined at 1, 3, 6, and 12 months.

Does routine stress-thallium cardiac scanning reduce postoperative cardiac complications?

Objective: Prophylactic cardiac revascularization in patients with ischemic myocardium could reduce postoperative cardiac complications after aortic reconstruction. However, the effectiveness of this approach has not been documented.

Summary Background Data: Stress-thallium scanning can identify patients with ischemic myocardium.

Affective self-report during the intracarotid sodium amobarbital test.

Changes in internal affective state were investigated in patients undergoing the intracarotid sodium amobarbital test. It was found that when the left hemisphere was inactivated, patients rated their mood as significantly more negative than during baseline conditions. No significant change in affective state was observed during the inactivation of the right hemisphere.

Old dyes for new scopes: the phagocytosis-dependent long-term fluorescence labelling of microglial cells in vivo.

The nature of the interactions between dying neurons and microglial cells within the developing and injured CNS remains controversial. A new technique for labelling microglial cells is available, which enables further studies of such interactions in a direct way. The value of the method relies on retrograde filling of neurons with vital fluorescent dye, subsequent degeneration of the neurons due to either naturally occurring cell death or as the result of axotomy, and phagocytotic removal of the fluorescent cell debris by microglial cells, which thus become identifiable.

Glutamine preserves gut glutathione levels during intestinal ischemia/reperfusion.

Intestinal ischemia/reperfusion (I/R) causes formation of reactive oxygen intermediates (ROI) which lead to mucosal cell injury. Glutathione (GSH), an ROI scavenger, protects tissues from ROI-mediated cell injury. Since GSH biosynthesis is partially dependent on glutamine (Gln) levels, we tested the hypothesis that intravenous Gln infusion will assist in maintaining mucosal cell GSH levels and decrease membrane lipid peroxidation during intestinal I/R.

Inefficacy of low-dose continuous oral etoposide in non-small cell lung cancer.

Etoposide is more active in small cell lung cancer when given over 5 days than as a single injection. To examine this concept further, we designed this Phase II study in NSCLC using continuous low-dose oral etoposide. We enrolled 19 patients with measurable disease and the standard eligibility criteria.

Rotational atherectomy for treatment of occluded prosthetic grafts.

Potentially, percutaneous rotational atherectomy (RA) can be used to open occluded prosthetic arterial bypass grafts with less morbidity than surgical catheter thrombectomy. However, RA could damage prosthetic grafts or produce significant distal emboli. To investigate this, acutely thrombosed and chronically occluded prosthetic grafts, harvested from dogs, were placed in an ex vivo perfusion system and recanalization was attempted using the TRAC-Wright rotational atherectomy system.