Cerebral effects of resuscitation with either epinephrine or vasopressin in an animal model of hemorrhagic shock.

Purpose: The use of epinephrine (EN) or vasopressin (VP) in hemorrhagic shock is well established. Due to its specific neurovascular effects, VP might be superior in concern to brain tissue integrity. The aim of this study was to evaluate cerebral effects of either EN or VP resuscitation after hemorrhagic shock.

Cerebral plasticity as the basis for upper limb recovery following brain damage.

Neural plasticity is the basis for an adaptation process of functional and structural characteristics of the nervous system in response to a changing environment. However, changes during training in healthy volunteers are only partially comparable to that observed in patients with circumscribed lesions. Pathologies can even be associated with maladaptive plasticity.

Microdialysis as a Part of Invasive Cerebral Monitoring During Porcine Septic Shock.

Background: Metabolic changes in critically ill patients with endotoxin-induced septic shock are measured primarily by techniques that afford organ-specific metabolic monitoring based on interstitial fluid samples. The present study was designed to evaluate the role of cerebral microdialysis (MD) as a part of invasive neuromonitoring during endotoxemia in a porcine model.

Materials And Methods: Continuous endotoxin infusion was administered to 7 female pigs and, in addition to hemodynamic monitoring and blood chemistry, interstitial lactate, pyruvate, glucose and glycerol concentrations in muscle, liver, and cerebral tissue were measured via in vivo MD for an observation period of 180 minutes.

Cerebral metabolism during experimental endotoxin shock and after preconditioning with monophosphoryl lipid A.

Purpose: Preconditioning with low doses of monophosphoryl lipid A (MPL) has been shown to induce endotoxin tolerance and to reduce the metabolic and hemodynamic consequences of endotoxin shock. However, no data are available about the effects of endotoxin preconditioning on cerebral metabolism during endotoxemia. The study was designed to determine the effects of endotoxin preconditioning with MPL on cerebral metabolism via microdialysis compared to muscle tissue metabolism during experimental endotoxemia.

Differences in reactivity of epoxides in the copolymerisation with carbon dioxide by zinc-based catalysts: propylene oxide versus cyclohexene oxide.

The homogeneous dinuclear zinc catalyst going back to the work of Williams et al. is to date the most active catalyst for the copolymerisation of cyclohexene oxide and CO(2) at one atmosphere of carbon dioxide. However, this catalyst shows no copolymer formation in the copolymerisation reaction of propylene oxide and carbon dioxide, instead only cyclic carbonate is found.

Representation of virtual arm movements in precuneus.

Arm movements can easily be adapted to different biomechanical constraints. However, the cortical representation of the processing of visual input and its transformation into motor commands remains poorly understood. In a visuo-motor dissociation paradigm, subjects were presented with a 3-D computer-graphical representation of a human arm, presenting movements of the subjects' right arm either as right or left arm.

Conformationally flexible dimeric salphen complexes for bifunctional catalysis.

Appropriate modification of the salphen ligand allows an easy modular design of flexibly linked dimeric salphen species and their complexes, which can act as bifunctional catalysts. A series of chromium salphen systems including monomeric compound and dimers with different spacer lengths were tested for their catalytic performance in β-butyrolactone polymerization and CO(2)/propylene oxide copolymerization toward biodegradable materials. The results clearly show an enhancement in activity upon dimerization, thus underlining the role of bifunctional catalysis in the studied processes and extending the possible strategies for improvement of catalysts in these reactions.

Distinct cortico-cerebellar activations in rhythmic auditory motor synchronization.

We investigated the role of the cerebellum in differential aspects of temporal control of rhythmic auditory motor synchronization using positron emission tomography (PET). Subjects tapped with their right index finger to metronome tones at a mean frequency of .8 Hz during 5 conditions: (1) an isochronous rhythm condition, (2) random changes in interval durations, and while the duration of rhythmic intervals was continuously time-modulated following a cosine-wave function at (3) 3%, (4) 7%, and (5) 20% of base interval.

Significant [C3a] increase in free flaps after prolonged ischemia.

Background: Free tissue transfer (FTT) represents a clinical model to measure ischemia-reperfusion injury (IRI). This study was conducted to detect substances relevant for IRI after FTT.

Methods: Eighteen patients underwent lower leg reconstruction with free myocutaneous latissimus dorsi muscles and were monitored clinically and by microdialysis technique.

Functional recovery of chronic ischemic myocardium after surgical revascularization correlates with magnitude of oxidative metabolism.

Background: The purpose of this study was to validate myocardial microdialysis measurements in patients after myocardial infarction with or without associated postoperative functional recovery in order to develop a highly sensitive tool for real-time in vivo detection of microcellular disorder during cardiac operations.

Methods: In 20 patients undergoing coronary artery bypass grafting, microdialysis catheters were implanted into scar or hibernating segments detected by means of magnetic resonance imaging, and into a vital area of the right ventricle (control). Myocardial glucose, lactate and pyruvate were analyzed perioperatively.

The metabolic and renal effects of adrenaline and milrinone in patients with myocardial dysfunction after coronary artery bypass grafting.

Introduction: Myocardial dysfunction necessitating inotropic support is a typical complication after on-pump cardiac surgery. This prospective, randomized pilot study analyzes the metabolic and renal effects of the inotropes adrenaline and milrinone in patients needing inotropic support after coronary artery bypass grafting (CABG).

Methods: During an 18-month period, 251 patients were screened for low cardiac output upon intensive care unit (ICU) admission after elective, isolated CABG surgery.

Analysis of the myocardial metabolism by microdialysis during open beating heart surgery.

Objectives: Microdialysis allows the in vivo biochemical analysis of interstitial fluids. Our aim was to reveal in vivo reliable data of the myocardium during open beating heart surgery.

Design: In ten patients undergoing routine beating coronary artery bypass grafting a microdialysis catheter was inserted into the left ventricle.

The effects of angiotensin-converting enzyme inhibition on the urinary excretion of NTproBNP in male volunteers.

Aims: This study was designed to test if the renal excretion of the N-terminal prohormone of the B-type natriuretic peptide (NTproBNP) is modulated by angiotensin-converting enzyme inhibition (ACE-I).

Methods: Following 7 days on a sodium-enriched diet and an induction period of 4 days with incremental dosages of enalapril (2.5, 5, 7.

Evaluation of myocardial metabolism with microdialysis during bypass surgery with cold blood- or Calafiore cardioplegia.

Background: For the first time, microdialysis was used to investigate in vivo and online the myocardial metabolism during and after cardiac surgery in patients treated with two different methods of myocardial protection.

Methods: Thirty patients underwent standard CABG with one of two different methods of myocardial protection. The patients were randomised to receive either cold blood (COLD group) or warm modified Calafiore cardioplegia (WARM group).

C3a levels and occurrence of subdermal vascular thrombosis are age-related in deep second-degree burn wounds.

Background: After second-degree burns, thrombosis of the subdermal vascular plexus may occur, necessitating epifascial necrectomy instead of tangential excision to ensure split skin graft healing. Until now, no parameter has been obtained to explain this phenomenon.

Methods: Thirty-four patients with deep second-degree burn wounds were divided into 2 groups.

Bench-to-bedside review: microdialysis in intensive care medicine.

Microdialysis is a technique used to measure the concentrations of various compounds in the extracellular fluid of an organ or in a body fluid. It is a form of metabolic monitoring that provides real-time, continuous information on pathophysiological processes in target organs. It was introduced in the early 1970s, mainly to measure concentrations of neurotransmitters in animal experiments and clinical settings.

The relationship between urotensin II plasma immunoreactivity and left ventricular filling pressures in coronary artery disease.

The role of urotensin II (U-II)--a vasoactive, mitogenic, and inotropic, peptide--in the pathophysiology of heart failure is controversial. The present study explores the relationship between plasma U-II immunoreactivity (U-IIIR) and hemodynamics in patients with coronary artery disease (CAD). Thirty-six patients with CAD-3 undergoing coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB) and 36 medical patients (MED group) with CAD-1 to CAD-3 during right heart catheterization were studied.

Na /H+ exchange inhibitor cariporide: effects on respiratory dysfunction after cardiopulmonary bypass.

The purpose of the present study was to evaluate the potential of the Na+/H+ exchange inhibitor cariporide to protect the lung from injury after cardiopulmonary bypass (CPB). In a randomized placebo-controlled study, 16 pigs were subjected to CPB for 75 min. Administration of vehicle or cariporide (bolus 180 mg, 40 mg/hour) began 30 min pre-CPB and was continued throughout the protocol.

Effects of tilting and volume loading on plasma levels and urinary excretion of relaxin, NT-pro-ANP, and NT-pro-BNP in male volunteers.

The polypeptide relaxin (RLX) has been suggested to play a role in cardiorenal integration and to be related to the natriuretic peptide system. We hence examined the effects of variations in thoracic blood volume and intravenous volume loading on plasma and urinary RLX levels and associated changes in natriuretic peptide levels in healthy men. Two groups of eight subjects were randomly tilted into a 15 degrees feet-down or a 15 degrees head-down position.