bluuebunny/crossref_metadata_2025 huggingface dataset:
The Comprehensive Antibiotic Resistance Database
Authors: McArthur Andrew G. , Waglechner Nicholas , Nizam Fazmin , Yan Austin , Azad Marisa A. , Baylay Alison J. , Bhullar Kirandeep , Canova Marc J. , De Pascale Gianfranco , Ejim Linda , Kalan Lindsay , King Andrew M. , Koteva Kalinka , Morar Mariya , Mulvey Michael R. , O'Brien Jonathan S. , Pawlowski Andrew C. , Piddock Laura J. V. , Spanogiannopoulos Peter , Sutherland Arlene D. , Tang Irene , Taylor Patricia L. , Thaker Maulik , Wang Wenliang , Yan Marie , Yu Tennison , Wright Gerard D.
Published: May 2013

The field of antibiotic drug discovery and the monitoring of new antibiotic resistance elements have yet to fully exploit the power of the genome revolution. Despite the fact that the first genomes sequenced of free living organisms were those of bacteria, there have been few specialized bioinformatic tools developed to mine the growing amount of genomic data associated with pathogens. In particular, there are few tools to study the genetics and genomics of antibiotic resistance and how it impacts bacterial populations, ecology, and the clinic. We have initiated development of such tools in the form of the Comprehensive Antibiotic Research Database (CARD;
http://arpcard.mcmaster.ca
). The CARD integrates disparate molecular and sequence data, provides a unique organizing principle in the form of the Antibiotic Resistance Ontology (ARO), and can quickly identify putative antibiotic resistance genes in new unannotated genome sequences. This unique platform provides an informatic tool that bridges antibiotic resistance concerns in health care, agriculture, and the environment.
The effect of changes in the score on injury incidence during three FIFA World Cups
Authors: Ryynänen Jaakko , Junge Astrid , Dvorak Jiri , Peterson Lars , Karlsson Jón , Börjesson Mats
Published: May 2013

Objective

To study the effect of changes in the score and of different playing positions, as well as the effect of recovery time on injury incidence during Fédération Internationale de Football Association (FIFA) World Cups.

Design

Prospective injury surveillance at three international championships in 2002, 2006 and 2010. Official match statistics were obtained for all the games played in the three championships.

Setting

2002, 2006 and 2010 FIFA World Cups.

Participants

National team players as well as the team doctors reporting all the injuries at the 2002, 2006 and 2010 FIFA World Cups.

Main outcome measures

Injury incidence and incidence rate ratios.

Results

There were statistically significant differences in injury incidence related to changes in the score (p=0.026) and to the teams’ current drawing/losing/winning status (p=0.008). Injury incidence was lowest (54.8/1000 match-hours (mh), 95% CI 46.4 to 64.3) during the initial 0–0 score and highest (81.2/1000 mh, 60.5 to 106.8) when the score was even but goals had been scored. Winning teams had a tendency towards a higher injury incidence (81.0/1000 mh, 67.5 to 96.4) than losing or drawing teams (55.5/1000 mh, 44.4 to 68.4 and 59.7/1000 mh, 51.8 to 68.6, respectively). There were also statistically significant differences in injury incidence between the playing positions (p<0.001), with forwards having the highest injury incidence (85.7/1000 mh, 69.8 to 104.2). There was a linear relationship (p=0.043) between an increasing number of recovery days between matches and a higher injury incidence.

Conclusions

There is a considerable variation in injury incidence during a match in international men's football related to changes in the score. Players in a winning team run a higher risk of suffering an injury than players in a drawing or losing team. Identifying time periods with a high injury incidence may be of major importance to players and team personnel, as it may enable them to take precautions.
Coupled consolidation analysis of pipe–soil interactions
Authors: Chatterjee Santiram , White David J. , Randolph Mark F.
Published: May 2013

Current design practice for pipe–seabed interaction in soft soils is generally based on the assumption of undrained behaviour throughout laying and subsequent operation. In reality, drainage and consolidation around a partially embedded pipe can have a marked effect on the vertical penetration and horizontal breakout resistance. In this paper, a large-deformation finite element methodology coupled with the “modified Cam clay” plasticity soil model has been developed to study the coupled consolidation behaviour of soil around partially embedded seabed pipelines. Simulations of penetration show that after laying, subsequent consolidation leads to further embedment by an amount dependent on the level of drainage that occurred during laying. Also, if the pipe is embedded under undrained conditions, the waiting period between laying and operation allows the soil around the pipe to consolidate under the pipe self-weight. The consolidation process results in an increase in the strength of the soil. The lateral breakout resistance and the direction of pipe movement on breakout thus depend on the consolidated strength of the soil around the pipe, as well as the applied loading. The envelopes of vertical–lateral combined loading bearing capacity differ markedly from those predicted assuming undrained behaviour throughout.
Rough approximation-based random model for quarry location and stone materials transportation problem
Authors: Xu Jiuping , Yin Yujie , Tao Zhimiao
Published: May 2013

This paper considers a bi-level multi-objective quarry location and stone materials transportation problem for a large-scale construction project with random phenomenon. Based on the characteristics and mechanisms of the problem, the objective functions and constraints are established. To deal with the problem uncertainty, an expected value operator is employed to deal with the random coefficients in the objective functions, and a rough approximation method is adopted to deal with the feasible region, which features constraints with random coefficients. Then a rough approximation-based bi-level multi-objective model is developed as an equivalent crisp model. To solve the complex and nonlinear bi-level multi-objective model, a hybrid genetic algorithm embedded with an interactive fuzzy programming technique is designed as a combined solution method. Finally, the results and a comparison analysis of a case study at the Xiluodu dam construction project are presented to demonstrate the practicality and efficiency of the optimization method.
NONTHERMAL QUANTUM BLACK HOLES WITH QUANTIZED MASSES
Authors: CALMET XAVIER , GAUSMANN NINA
Published: May 2013

In this paper, we discuss nonthermal quantum black holes with a discrete mass spectrum and their possible new signatures at the LHC. We calculate the inclusive cross-sections for the production of quantum black holes with discrete masses at the LHC as well as some exclusive cross-sections for particularly interesting decay modes.
A CLOSED ALGEBRA WITH A NON-BOREL CLONE AND AN IDEAL WITH A BOREL CLONE
Authors: GOLDSTERN MARTIN , PINSKER MICHAEL , SHELAH SAHARON
Published: May 2013

Algebras on the natural numbers and their clones of term operations can be classified according to their descriptive complexity. We give an example of a closed algebra which has only unary operations and whose clone of term operations is not Borel. Moreover, we provide an example of a coatom in the clone lattice whose obvious definition via an ideal of subsets of natural numbers would suggest that it is complete coanalytic, but which turns out to be a rather simple Borel set.
QUANTIZATION OF THE G-CONNECTIONS VIA THE TANGENT GROUPOID
Authors: LAI ALAN
Published: May 2013

A description of the space of G-connections using the tangent groupoid is given. As the tangent groupoid parameter is away from zero, the G-connections act as convolution operators on a Hilbert space. The gauge action is examined in the tangent groupoid description of the G-connections. Tetrads are formulated as Dirac type operators. The connection variables and tetrad variables in Ashtekar's gravity are presented as operators on a Hilbert space.
A SIMPLER SOLUTION OF THE NON-UNIQUENESS PROBLEM OF THE COVARIANT DIRAC THEORY
Authors: ARMINJON MAYEUL
Published: May 2013

Although the standard generally covariant Dirac equation is unique in a topologically simple spacetime, it has been shown that it leads to non-uniqueness problems for the Hamiltonian and energy operators, including the non-uniqueness of the energy spectrum. These problems should be solved by restricting the choice of the Dirac gamma field in a consistent way. Recently, we proposed to impose the value of the rotation rate of the tetrad field. This is not necessarily easy to implement and works only in a given reference frame. Here, we propose that the gamma field should change only by constant gauge transformations. To get that situation, we are naturally led to assume that the metric can be put in a space-isotropic diagonal form. When this is the case, it distinguishes a preferred reference frame. We show that by defining the gamma field from the "diagonal tetrad" in a chart in which the metric has that form, the uniqueness problems are solved at once for all reference frames. We discuss the physical relevance of the metric considered and our restriction to first-quantized theory.
FEWSS — FRAMEWORK TO EVALUATE THE SERVICE SUITABILITY AND PRIVACY IN A DISTRIBUTED WEB SERVICE ENVIRONMENT
Authors: CHANDRAMOHAN D. , VENGATTARAMAN T. , DHAVACHELVAN P. , BASKARAN R. , VENKATACHALAPATHY V. S. K.
Published: May 2013

This paper focuses on addressing the problem of web service monitoring by evaluating its suitability and privacy in a distributed web service environment (DWS). The need for web services monitoring and evaluation is necessary because the quantity and quality of retrieved web services generally does not fulfill the demands or requirements of the web service requesters. In the literature, many authors proposed suitable solutions for checking the quality of web service in an ad hoc scenario but there is no available testbed for this purpose. In this work, it is proposed to develop a framework as a testbed for evaluating the web service for its suitability and privacy. In order to verify, the retrieved web services fulfill the demands and requirements of the requester in a DWS environment. The Framework to Evaluate the Web Service Suitability (FEWSS) supports service providers in modeling the services with testbed and to design service behavior to comply the service suitability. It generates run-time instances of web services, client's requests, service registries and other entities in order to emulate realistic SOA environments. By generating a real testbed, our approach assists in runtime test for provider system/services. Particular focus has been put on the privacy policy extensibility to allow the service providers and users in a complex environment. FEWSS also provides an intuitive interface for testing all services under SOA control.
CEACAM1 Expression in Oligodendrocytes of the Developing Rat Brain Shows a Spatiotemporal Relation to Myelination and Is Altered in a Model of Encephalopathy of Prematurity
Authors: Prager Sebastian , Singer Bernhard B. , Bendix Ivo , Schlager Gerald W. , Bertling Frederik , Ceylan Burcin , Keller Matthias , Felderhoff-Mueser Ursula , Ergün Süleyman
Published: May 2013

CEACAM1 is the founder molecule of the family of ‘carcinoembryonic antigen-related cell adhesion molecules' and part of the immunoglobulin superfamily. Due to its role as a coreceptor to many other receptors (e.g. Toll-like receptor 2, Toll-like receptor 4, T-cell receptor, B-cell receptor, epidermal growth factor receptor and vascular endothelial growth factor receptor) and its different isoforms, CEACAM1 is a multifunctional protein with an impact on proliferation and differentiation of multiple cell types. Although different modes of action in other tissues are described, the role of CEACAM1 in the developing brain remains elusive. Here we report for the first time that CEACAM1 is expressed ontogenetically in oligodendrocytes of the developing rat brain, and that CEACAM1 expression has a spatiotemporal relation to myelination. In addition, CEACAM1 expression is altered in a model of hyperoxia- and inflammation-induced encephalopathy of prematurity, a myelination disorder of children born preterm. Furthermore, primary oligodendrocytes stimulated with CEACAM1 show increased myelination. Therefore, we postulate that CEACAM1 is, at least in part, involved in hyperoxia- and inflammation-induced disruption of myelination, but may also play a role in intact myelination as it is ontogenetically expressed in myelinating oligodendrocytes.
A Qualitative Seminested PCR Assay as an Alternative to Urine Cytology for BK Polyomavirus Screening after Renal Transplantation
Authors: Zalona Ana Carolina Jonard , Varella Rafael Brandão , Takiya Cristina Maeda , Goncalves Renato Torres , Zalis Mariano Gustavo , Santoro-Lopes Guilherme
Published: May 2013

Objective: Polyomavirus-associated nephropathy (PVAN) is a major cause of graft dysfunction after kidney transplantation. Therefore, routine screening for BK polyomavirus (BKV) infection with urine cytology or quantitative PCR-based assays has been recommended. Although less expensive than quantitative tests, qualitative PCR assays are not recommended for screening based on the assumption that their diagnostic accuracy is inferior to urine cytology. However, studies comparing the performance of both methods are scarce. Methods: We compared the accuracy between a qualitative seminested PCR (snPCR) assay and urine cytology for the screening of BKV viruria in 104 renal transplant recipients. Results: The snPCR assay was more sensitive than cytology (100 and 61%, respectively), yielding better negative predictive value (100 vs. 90%). In 7 (39%) of the 18 PVAN cases, BKV infection was detected exclusively by snPCR. Although the specificity of snPCR (63%) was lower than cytology (74%), their positive predictive values were similar (36 vs. 33%, respectively). In ROC curve analysis, the accuracy of snPCR was significantly higher (p = 0.03). Conclusion: This qualitative snPCR assay was more accurate than urine cytology for the detection of BKV viruria in renal transplant patients.
Study of Primary IGF-1 Deficiency in Egyptian Children with Idiopathic Short Stature
Authors: Anwar Ghada M. , Kandeel Wafaa A. , Mandour Iman A. , Kamal Ayat N.
Published: May 2013

Background/Aims: Primary insulin-like growth factor-1 (IGF-1) deficiency (IGFD) is defined by low levels of IGF-1 without growth hormone (GH) deficiency and absence of secondary causes. The aim of this study was to evaluate IGF-1 in Egyptian children with idiopathic short stature (ISS) and describe patients with IGFD. Methods: This cross-sectional study included 50 children with ISS following up at the Diabetes Endocrine and Metabolism Pediatric Unit at Cairo University Pediatric Hospital. Children were included based on the following criteria: (1) short stature with current height standard deviation score (SDS) ≤-2.5; (2) age between 2 and 9 years in boys and 2 and 8 years in girls, and (3) prepubertal status. Exclusion criteria were: (1) identified cause of short stature and (2) pubertal children. IGF-1-deficient children were defined as children without GH deficiency and with IGF-1 levels below the 2.5th percentile. Results: Among 50 children with ISS, 14 (28%) patients had low IGF-1 levels, consistent with the diagnosis of primary IGFD. When compared with non-IGFD children, IGFD children had lower birth weight SDS (-1.8 vs. -0.7 SDS, p < 0.0001) and lower height SDS (-4.2 vs. -3.1 SDS, p < 0.05) and more delayed bone age (2.6 vs. 1.6 years, p = 0.001). Conclusion: Primary IGF-1 deficiency is found in 28% of children with ISS.
An Empirical Reevaluation of Absolute Pitch: Behavioral and Electrophysiological Measurements
Authors: Elmer Stefan , Sollberger Silja , Meyer Martin , Jäncke Lutz
Published: May 2013

Here, we reevaluated the “two-component” model of absolute pitch (AP) by combining behavioral and electrophysiological measurements. This specific model postulates that AP is driven by a perceptual encoding ability (i.e., pitch memory) plus an associative memory component (i.e., pitch labeling). To test these predictions, during EEG measurements AP and non-AP (NAP) musicians were passively exposed to piano tones (first component of the model) and additionally instructed to judge whether combinations of tones and labels were conceptually associated or not (second component of the model). Auditory-evoked N1/P2 potentials did not reveal differences between the two groups, thus indicating that AP is not necessarily driven by a differential pitch encoding ability at the processing level of the auditory cortex. Otherwise, AP musicians performed the conceptual association task with an order of magnitude better accuracy and shorter RTs than NAP musicians did, this result clearly pointing to distinctive conceptual associations in AP possessors. Most notably, this behavioral superiority was reflected by an increased N400 effect and accompanied by a subsequent late positive component, the latter not being distinguishable in NAP musicians.
Tool Selectivity in Left Occipitotemporal Cortex Develops without Vision
Authors: Peelen Marius V. , Bracci Stefania , Lu Xueming , He Chenxi , Caramazza Alfonso , Bi Yanchao
Published: May 2013

Previous studies have provided evidence for a tool-selective region in left lateral occipitotemporal cortex (LOTC). This region responds selectively to pictures of tools and to characteristic visual tool motion. The present human fMRI study tested whether visual experience is required for the development of tool-selective responses in left LOTC. Words referring to tools, animals, and nonmanipulable objects were presented auditorily to 14 congenitally blind and 16 sighted participants. Sighted participants additionally viewed pictures of these objects. In whole-brain group analyses, sighted participants showed tool-selective activity in left LOTC in both visual and auditory tasks. Importantly, virtually identical tool-selective LOTC activity was found in the congenitally blind group performing the auditory task. Furthermore, both groups showed equally strong tool-selective activity for auditory stimuli in a tool-selective LOTC region defined by the picture-viewing task in the sighted group. Detailed analyses in individual participants showed significant tool-selective LOTC activity in 13 of 14 blind participants and 14 of 16 sighted participants. The strength and anatomical location of this activity were indistinguishable across groups. Finally, both blind and sighted groups showed significant resting state functional connectivity between left LOTC and a bilateral frontoparietal network. Together, these results indicate that tool-selective activity in left LOTC develops without ever having seen a tool or its motion. This finding puts constraints on the possible role that this region could have in tool processing and, more generally, provides new insights into the principles shaping the functional organization of OTC.
Soil insect research in South Africa. 1. A new genus of terricolous weevils with four new species from the Richtersveld National Park (Coleoptera: Curculionidae: Entiminae: Trachyphloeini)
Authors: BOROVEC R. , MEREGALLI M.
Published: May 2013

The new genus, Nama gen. n., and four new species, N. richtersveldiana sp. n., N. pentamera sp. n., N. iuliae sp. n. and N. erikae sp. n., are described from the Richtersveld National Park. The taxonomic position of the new genus is discussed, and it is compared with the other Trachyphloeini native to South Africa and with some genera of Trachy-phloeini occurring in the Palaearctic region. A key to the species of Nama is provided.
Review of the Chinese species of Gynnidomorpha Turner, 1916 (Lepidoptera: Tortricidae: Cochylini)
Authors: SUN YINGHUI , LI HOUHUN
Published: May 2013

Ten species of Gynnidomorpha Turner, 1916 occur in China. Gynnidomorpha curviphalla, sp. nov., is described, and G. datetis (Diakonoff, 1984) is recorded from China for the first time. Images of adults and genitalia are provided, along with a key to all known Chinese species based on the male genitalia. A map showing the geographic distribution of the species is also provided.
A new species of the rare nematode genus Margollus Peña-Santiago, Peralta & Siddiqi, 1993 (Nematoda: Tylencholaimoidea) from Turkey
Authors: AHMAD WASIM , AHAD SUMAYA , STURHAN DIETER
Published: May 2013

Margollus turcicus sp. n., is described and illustrated from vineyard soil in Turkey. The new species is characterized by having a medium sized body (L=1.0–1.2 mm); cuticle with distinct striations; radial refractive elements abundant; lip re-gion distinctly narrower than the adjoining body and slightly offset from the body contour by a depression; cephalic and labial papillae not discernible; strong labial and post-labial sclerotization present; amphids well developed with sclero-tized walls; stylet 27–28.5 μm long, odontophore distinctly flanged, 0.3 times the odontostyle length; pharyngeal bulb off-set by constriction, 33–37 μm long; mono-opisthodelphic female genital system with anterior branch 22–41 μm long; spicules 49 μm long; single weak ventromedian supplement and short hemispheroid tail in both sexes.
Redescription of Lystrocteisa Simon, 1884 (Araneae: Salticidae) from New Caledonia
Authors: PATOLETA BARBARA , GARDZIŃSKA JOANNA
Published: May 2013

The monotypic jumping spider genus Lystrocteisa Simon, 1884 is redescribed. A new generic diagnosis is provided, based on both sexes, together with redescriptions of the male and description and illustration of the hitherto unknown female of the type species.
Lamprista gen. nov. of Lecithoceridae (Lepidoptera, Gelechioidea) from New Guinea, with descriptions of two new species
Authors: PARK KYU-TEK , LEE SANGMI
Published: May 2013

Lamprista gen. nov., morphologically allied to Crocanthes Meyrick, 1886, is described from New Guinea, based on the type species, L. emmeli sp. nov., and an additional species, L. ortholepida sp. nov., is described. Illustrations of the imagos, male and female genitalia, and wing venation of the new species are given. A new combination from Crocanthes is proposed: Lamprista hemipyra (Meyrick, 1938), comb. nov. A key to the species of Lamprista is given.
Regional Policies, Firm Characteristics and Exporting in the Indian State of Karnataka
Authors: Pradhan Jaya Prakash , Zohair Mohammad , Alagawadi Mallikarjun V.
Published: May 2013

Karnataka is among pioneering Indian states to frame suitable policies aimed at encouraging local firms’ export activities. Promotion and facilitation of firms to look beyond national market was achieved by creating a strong enabling institutional framework, supporting expansion of productive capacity and helping exporting firms gain access to required physical infrastructure. As a result of such policies, exports from the Karnataka have been growing rapidly, with Karnataka contributing over half a quarter of Indian exports of commodities and software. The present study provides an overview of export trends and patterns of Karnataka in the backdrop of the state policy developments. It examines the relevance of various factors pertinent to the exports by Karnataka manufacturing firms and deduces implications for development policy of the state.
Reviving Democratic Citizenship?
Authors: Ackerman Bruce
Published: May 2013

Many of our inherited civic institutions are dead or dying. We need an ambitious reform program to revive democratic life. This essay advances a four-pronged “citizenship agenda”: (1) a campaign finance initiative granting each voter fifty “patriot dollars” to fund candidates and political parties of his or her choice; (2) a proposal for a new national holiday, Deliberation Day, held before each national election, enabling citizens to deliberate on the merits of rival candidates; (3) a system of federally financed electronic news-vouchers to permit professional journalism to survive the destruction of its traditional business model; and (4) a new form of citizenship inheritance, which provides $80,000 to all Americans as they start off life as adults. Working with collaborators, I have developed each of these initiatives at book length. This essay suggests how the “citizenship agenda” yields a whole that is larger than the sum of its parts.
Early Postoperative Thrombosis of Pericardial Xenograft Aortic Valve
Authors: Mestres Carlos-A , García-Real F Javier , Fuentes Manuel
Published: May 2013

Thromboembolic complications and valve thrombosis in pericardial xenografts are rare. A case of early postoperative thrombosis of a pericardial xenograft is described.
Aortic Valve Reconstruction: Midterm Results from Central Chest Hospital
Authors: Chotivatanapong Taweesak , Chaiseri Praditchai , Kasemsarn Choosak , Yotthasurodom Chaiwut , Sungkahapong Vibhan , Cholitkul Sireethorn
Published: May 2013

From September 1994 to September 1999, 50 patients underwent successful aortic valve reconstruction. Four were lost to follow-up, there were 2 early and 2 late deaths. The remaining 35 males and 11 females (mean age, 39.1 years) were followed up for 1 to 61 months (mean, 30.75 months). Most had rheumatic disease (27), the others had infective endocarditis (16) or degenerative disease (3). There was isolated aortic valve disease in 22 cases, double-valve disease in 16, triple-valve disease in 7, and 1 other. Preoperative aortic regurgitation was severe in most cases and the mean ejection fraction was 55.3%. Surgical procedures included subcommissural annuloplasty (14), cusp thinning (13), commissurotomy (10), and free-edge unrolling (10). Cusp extension with autologous pericardium was performed in 9 patients and aortic valve replacement with autologous pericardium in 22. Nine patients needed aortic valve replacement at a mean of 15.8 months postoperatively. The other 33 patients experienced marked improvements in aortic valve function. Aortic valve reconstruction is recommended in selected patients but reoperation remains an important problem. Long-term follow-up is needed to assess the role of this operation.
Superior Vena Cava Syndrome Due to Metastatic Transitional Cell Carcinoma
Authors: Shrestha Bishwo Man Singh , Koirala Bhagwan , Joshi Purna Raj , Marhatha Mod Nath , Sharma Govind Prasad , Joshi Bhola Raj , Bhatta Mahendra , Sayami Gita , Koirala Ramesh , Rajbhandari Laxmi
Published: May 2013

Superior vena cava syndrome due to infradiaphragmatic tumor metastasis was detected in a 70-year-old man. A tumor attached to the right atrial wall was excised and subsequent transurethral resection of a bladder tumor revealed high-grade transitional cell carcinoma. The disease progressed and the patient died 6 months later.
Retrograde Coronary Sinus Perfusion for Severe Left Main Stenosis
Authors: Sajja Lokeswara Rao , Farooqi Afroz , Yarlagadda Ramesh Babu , Mastan Saheb Shaik , Pothineni Ramesh Babu
Published: May 2013

Between April 1996 through March 1999, 15 patients with severe (> 60%) left main coronary artery stenosis became hemodynamically unstable on induction of anesthesia, in spite of optimal pharmacological management. Retrograde coronary sinus perfusion was instituted soon after the median sternotomy to improve hemodynamics until the establishment of cardiopulmonary bypass after harvesting internal mammary artery and saphenous vein grafts.
Excision of Aortic Vegetation in Brucella Endocarditis
Authors: Duran Enver , Sunar Hasan , Ege Turan , Canbaz Suat , Akata Filiz , Özbay Gültaç
Published: May 2013

A 19-year-old man with brucella endocarditis was treated by antimicrobial therapy and surgical excision of vegetation with preservation of the native aortic valve.
Delayed Sternal Closure after Cardiac Operations
Authors: Mubeen Mohammad , Dan Surajit , Agarwal Surendra Kumar , Srivastava Ashok Kumar , Kanhere Vivek M
Published: May 2013

In 1,459 open heart operations performed between July 1995 and March 2000, sternal closure was delayed in 30 patients (2%) because of hemodynamic instability limiting primary sternal closure in 12 and uncontrollable bleeding in 18. Two patients died in the immediate postoperative period while the chest was open, due to persistent low cardiac output secondary to myocardial failure. The sternum was closed in 28 patients at an average of 22 ± 0.3 hours (range, 8 to 48 hours) postoperatively. Two patients died in the late postoperative period prior to hospital discharge after sternal closure. Nonfatal wound infections occurred in 8 patients. The 26 survivors (86.7%) were discharged and followed up for a mean of 11.2 months. This study demonstrates that delayed sternal closure is an effective method of dealing with unstable hemodynamics and uncontrollable hemorrhage.
Extensive Left Atrial Tear during Mitral Valve Replacement: A Word of Caution
Authors: Bedi Harinder Singh , Kalkat Maninder Singh , Nayyar Ashwani
Published: May 2013

An extensive left atrial tear was encountered in a 70-year-old woman undergoing valve surgery. This potentially fatal complication was successfully repaired with autologous pericardium.
Closure of Bronchial Defects Using Glutaraldehyde-Treated Pericardium
Authors: Dhaliwal Rajinder S , Puri Deepak , Sidhu Kuldip S
Published: May 2013

From September 1992 to December 2000, closure of bronchial defects in 9 patients was achieved with a glutaraldehyde-treated autologous free pericardial patch. Four patients underwent an upper lobectomy and 2 had a lower lobectomy. Two patients had traumatic disruption of the main bronchus, and 1 had disruption of the right bronchus intermedius. Airtight closure of the bronchial defect was accomplished in all cases, and the remaining lung expanded easily. There was no suture line breakdown, bronchial stenosis, or obstruction during follow-up ranging from 3 to 96 months. Pericardial patch bronchoplasty is a technically simpler and safe alternative to complex bronchoplasty procedures.
Intravascular Detection of Ischemia by Near-Infrared Spectroscopy
Authors: Baykut Doan , Kadipasaoğlu Kâmuran A , Bölükoglu Hakki , Gebhard Martha-Maria , Frazier O Howard , Zerkowski Hans-Reinhard
Published: May 2013

The interruption of myocardial oxygen supply in acute ischemia alters the O2 content of coronary venous blood. The oxygenation status of coronary sinus blood was assessed by intravascular application of near-infrared spectroscopy in 10 domestic pigs under in-vivo conditions. Calibration of the catheter was performed in vitro by perfusion of blood with gas mixtures of various O2 concentrations. The catheter was placed into the coronary sinus, and anterior wall ischemia was induced by temporary occlusion of the left anterior descending coronary artery. Spectroscopic and hemodynamic data were obtained. The main differences between oxygenated and deoxygenated hemoglobin were found with O2 concentrations < 30%, corresponding to the coronary sinus blood O2 content. Spectrographs showed variations related to CO2 concentration, pH, and temperature. Spectral analysis showed significant differences between pre-ischemia and ischemia. Variations in spectrographs could be observed in both in-vitro and in-vivo experiments. The intravascular application of near-infrared spectroscopy is technically feasible and can be used as a reliable tool in detection and follow-up of tissue deoxygenation, particularly in acute myocardial ischemia.
Clinical Effects of Different Protamine Doses after Cardiopulmonary Bypass
Authors: Svenarud Peter , Øvrum Eivind
Published: May 2013

The optimal dose of protamine needed to reverse the anticoagulant effect of heparin after cardiopulmonary bypass is still not known. In this retrospective cohort study, we investigated 3 different dose regimes in 300 patients undergoing coronary artery bypass grafting. Group A patients (n = 100) were given protamine in the ratio of 1.3 mg to 1 mg heparin, group B patients (n = 100) were given 0.75 mg protamine to 1 mg heparin, and group C patients (n = 100) were given protamine in fractionated doses of 1 mg + 0.15 mg + 0.15 mg to 1 mg heparin. The groups were comparable in all major clinical and operative variables. The heparin dose was almost identical in the groups. The rate of red cell transfusion was significantly higher in group B than in the other groups. A similar but nonsignificant trend was observed in the incidence of resternotomy for postoperative bleeding, mediastinal drainage, and postoperative hemoglobin loss. The study demonstrates that a single bolus dose of 1.3 mg protamine to 1 mg heparin is safe and efficient for neutralizing heparin after cardiopulmonary bypass.
Correction of Absent Pulmonary Valve Syndrome Using a Pericardial Valved Conduit
Authors: Attanawanich Sukasom , Khowsathit Pongsak , Withurawanit Wichaya
Published: May 2013

Absent pulmonary valve syndrome in a 4-month-old infant was successfully corrected using a fresh autologous pericardial trileaflet valved conduit. He recovered from operation with only mild pulmonary regurgitation at 4 months postoperatively. This technique is an effective alternative for infants with congenital heart disease who need tissue valved conduits. It may be more suitable than the aortic homograft by reason of the shortage of small homografts and its lower costs.
Anomalous Connection of Left Circumflex Artery to Pulmonary Artery
Authors: Mirkhani Seyed Hamid , Delavarkhan Morteza , Bayat Homeyra , Sanatkar Mahdi
Published: May 2013

A 52-year-old woman was evaluated for chest discomfort and dyspnea on exertion. Coronary angiography demonstrated an anomalous connection between the left circumflex artery and the right pulmonary artery. Successful repair was achieved under cardiopulmonary bypass, and the patient became completely symptom-free.
Acquired Tracheoesophageal Fistula following Blunt Trauma to the Chest
Authors: Karunaratne Bambarawane LA , Gooneratne Panini A , Wijesekara Savitri , Goonetilleke Gamini
Published: May 2013

Tracheoesophageal fistula following blunt chest trauma is rare. Typically the patient is a young male with an elastic chest wall who is involved in a motor vehicle accident. In this case the victim was a motorcyclist who collided with a stationary lorry. He underwent surgery 4 weeks after the injury made an uncomplicated recovery.
Cardiac Morphology in Lung Volume Reduction Surgery for Endstage Emphysema
Authors: Vigneswaran Wickii T , Chomka Eva V , Jelnin Vladmir , Hernan M Janeen , Podbielski Francis J
Published: May 2013

Lung volume reduction surgery for endstage emphysema produces significant improvements in various pulmonary parameters, but its effects on cardiac morphology and function have not been clearly defined. Ten patients scheduled for lung volume reduction surgery underwent pulmonary function testing, right-heart catheterization, and electron beam computed tomography of the heart. These studies were repeated 12–16 weeks after the procedure. Quantitative assessments of right and left ventricular function and left ventricular muscle mass were obtained. Postoperatively, all patients showed significant improvements in forced expiratory volume at one minute compared to the preoperative value (1.57 ± 0.24 L versus 1.10 ± 0.21 L), predicted residual lung volume (115% ± 15% versus 205% ± 15%), and 6-minute walk test (318 ± 17 m versus 267 ± 24 m). There were no significant differences between postoperative and preoperative right ventricular end-diastolic volumes (167.3 ± 21.2 mL versus 169.2 ± 17.3 mL) or left ventricular end-diastolic volumes (112.5 ± 10.2 mL versus 119.2 ± 9.7 mL).
Unruptured Sinus of Valsalva Aneurysm with Right Ventricular Outflow Obstruction
Authors: Mohanakrishnan Laxmanan , Vijayakumar Koyilil , Sukumaran Ponnusamy , Menon Narendra , Prabu Chinnasamy Rangarajan , Balaji Soundararajan , Manoharan Subramaniam
Published: May 2013

The recommended operative management of unruptured sinus of Valsalva aneurysm consists of closure of the mouth of the aneurysm with or without aortic valve surgery. We report a case of unruptured aneurysm producing right ventricular outflow tract obstruction. Closure of the mouth of the aneurysm failed to relieve the obstruction, which was subsequently achieved by excising the aneurysmal wall overlying the outflow tract.
Intermittent Tepid Blood Cardioplegia Improves Clinical Outcome
Authors: Tan Teing Ee , Ahmed Sulman , Paterson Hugh S
Published: May 2013

Intermittent antegrade cold blood cardioplegia is the predominant method of myocardial protection, but recent studies suggest that warm or tepid blood cardioplegia may improve the return of myocardial metabolic and contractile function. Data were collected prospectively on 1,533 patients undergoing cardiopulmonary bypass in a single surgeon's practice. The use of intermittent antegrade cold (4°C) blood cardioplegia in 951 consecutive patients from September 1994 to November 1997 was compared with intermittent antegrade tepid (28°C) blood cardioplegia in 582 consecutive patients from July 1998 to July 2000. The two groups were similar, but the symptom class was more severe and there were more redo and combined procedures and more operations within 7 days of myocardial infarction in the tepid group. Significant clinical benefits identified in the tepid group included reduced usage of intraaortic balloon pumping postoperatively (4.4% versus 2.2%) and reduced incidence of postoperative atrial fibrillation (25.7% versus 20.6%). There was no significant difference in mortality, perioperative myocardial infarction, cerebrovascular events, or use of inotropics between the groups. Intermittent tepid blood cardioplegia is clinically appropriate and safe to use in patients undergoing cardiac surgery.
Aortic Valve Replacement in a Patient with an Aberrant Left Coronary Artery
Authors: Alsaddique Ahmed A. , Elsaegh Mohammed M. , Fouda Mohammed A.
Published: May 2013

A 22-year-old male undergoing aortic valve replacement was found to have the left coronary ostium arising from the noncoronary cusp area in close proximity to the annulus. He could not be weaned off cardiopulmonary bypass after the operation, even after removal of a Teflon pledget thought to obstruct the left coronary ostium. He underwent bypass grafting to the left coronary system and was then easily weaned off cardiopulmonary bypass.
Doppler Echocardiographic Evaluation of Prosthetic Valves in Tricuspid Position
Authors: Aoyagi Shigeaki , Tomoeda Hiroshi , Kawano Hiroshi , Yokose Shogo , Fukunaga Shuji
Published: May 2013

Doppler echocardiographic characteristics of 29 normally functioning prosthetic valves (23 mechanical, 6 biological) and 8 obstructed mechanical prostheses in the tricuspid position are reported. In normally functioning prostheses, peak velocity, mean pressure gradient, and pressure-half time were 1.25 ± 0.18 m·sec−1, 2.6 ± 1.1 mm Hg, and 122.6 ± 30.7 msec, respectively. Although no significant differences were seen in peak velocity and mean pressure gradient between mechanical and biological valves, the pressure half-time was significantly greater in biological valves. All normally functioning prostheses had a mean pressure gradient ⩽5.5 mm Hg and pressure half-time < 200 msec. In obstructed bileaflet valves, peak velocity was 1.66 ± 0.28 m·sec−1, mean pressure gradient was 6.1 ± 2.8 mm Hg, and pressure half-time was 265.8 ± 171.7 msec. These Doppler data were significantly greater than those in normally functioning valves where the mean pressure gradient was ⩽5.1 mm Hg and the pressure half-time was ⩽156 msec in all except one patient. Pathological obstruction of a tricuspid prosthesis can be strongly suspected in patients with a mean pressure gradient > 5.5 mm Hg and a pressure half-time > 200 msec on Doppler echocardiography.
Soluble Adhesion Molecules in Coronary Artery Bypass Surgery
Authors: Wei Minxin , Laurikka Jari , Kuukasjärvi Pekka , Pehkonen Erkki , Tarkka Matti
Published: May 2013

Plasma levels of sE-selectin, sP-selectin, and sICAM-1 were measured before anesthesia and at 0.5, 4, and 20 hours after cardiopulmonary bypass in 37 men undergoing coronary artery bypass surgery. Plasma sE-selectin remained close to the preoperative levels. The levels of sP-selectin increased significantly from 46.5 ± 15.3 ng·mL−1 to 69.3 ± 39.6 ng·mL−1 at 0.5 hours, 84.1 ± 45.5 ng·mL−1 at 4 hours, and 79.6 ± 35.5 ng·mL−1 at 20 hours. Plasma sICAM-1 levels decreased 0.5 hours after cardiopulmonary bypass, recovered at 4 hours, and showed a significant increase at 20 hours. The changes in plasma levels of adhesion molecules did not correlate with the duration of bypass or aortic crossclamping, hemodynamics, or creatine kinase-MB levels. However, sE-selectin and sICAM-1 levels increased considerably more in patients who needed norepinephrine in the intensive care unit. These results indicate that the transient changes in plasma levels of soluble adhesion molecules are not associated with postoperative myocardial injury in low-risk coronary grafting, although they correlate with the need for a vasopressor.
Biatrial Pacing to Prevent Atrial Fibrillation after Coronary Artery Bypass
Authors: Au Wing-Kuk , Chiu Shiu-Wah , Sun Man-Ping , Cheung Lik-Ching , Cheng Lik-Cheung
Published: May 2013

Between October 1999 and December 2000, 52 patients (37 male) undergoing coronary artery bypass surgery were selected for overdrive biatrial pacing to determine its effectiveness in reducing atrial fibrillation. A pacing wire was attached to the right atrial appendage and another to the roof of the left atrium behind the aorta. The atria were paced continuously in AAI mode at a rate of 90 pulses per minute or 10 pulses above the underlying rate (maximum rate < 140/min) for 3 days. The endpoint was the onset of atrial fibrillation during hospital stay. Results were compared with those of a control group of 52 matched patients. There were no significant differences in the occurrence of atrial fibrillation (30% in the paced group vs. 25% in the control group), morbidity, or length of hospital stay. Continuous biatrial pacing after coronary bypass surgery was safe and well tolerated, however, it did not prevent or lower the incidence of atrial fibrillation.
Arterial Switch Operation without Coronary Translocation: Mid-Term Results
Authors: Murthy Kona Samba , Coelho Robert , Kulkarni Snehal , Ninan Benjamin , Cherian Kotturathu Mammen
Published: May 2013

We innovated a technique of arterial switch operation without coronary translocation in 1995, which avoids problems related to coronary artery translocation with good mid-term results. It is a better alternative for surgeons who are not well versed with coronary translocation of conventional arterial switch operation and with difficult coronary anatomy. This report deals with the mid-term results of our new technique.
Impact of Size, Histology, and Gender on Stage IA Non-Small Cell Lung Cancer
Authors: Campione Andrea , Ligabue Tommaso , Luzzi Luca , Ghiribelli Claudia , Paladini Piero , Voltolini Luca , Di Bisceglie Maurizio , Lonzi Mario , Gotti Giuseppe
Published: May 2013

The aim of this study was to assess which prognostic factors could influence survival in surgically treated stage IA non-small cell lung cancer. The records of 224 consecutive patients with pathological stage IA after radical surgery were reviewed retrospectively. Overall 1, 3 and 5-year survival rates were 89%, 76%, and 66%. Nearly half of the deaths were unrelated to the original cancer. There was no difference in survival attributable to preoperative pulmonary function, age at operation, or extent of resection. However, patients with limited resections had a higher rate of local recurrence. Survival was better with a smaller size of tumor (= 2 cm), in the female sex, and in cases of bronchoalveolar adenocarcinoma.
Type B Dissection Complicated with Subacute Visceral Ischemia
Authors: Yamashiro Satoshi , Kuniyoshi Yukio , Miyagi Kazufumi , Uezu Toru , Arakaki Katsuya , Koja Kageharu
Published: May 2013

A 63-year old man presented with back pain and abdominal pain that worsened after eating. Contrast-enhanced computed tomography revealed type B aortic dissection. Arteriography 20 days after dissection revealed celiac trunk stenosis and the superior mesenteric artery did not arise from the true lumen. Saphenous vein bypass grafting from the right common iliac artery to the superior mesenteric and gastroduodenal arteries was performed. The postoperative course was uneventful and the abdominal symptoms completely disappeared.
Blood-Air Interface during Cardiopulmonary Bypass
Authors: Kiessling Arndt-H , Khalil Mahmud , Assaf Ohmed , Isgro Frank , Kretz Kai-U , Saggau Werner
Published: May 2013

The aim of this study was to compare the systemic blood activation with open and closed perfusion management during cardiopulmonary bypass. In 30 patients undergoing coronary artery bypass grafting, we prospectively studied systemic blood activation, blood loss and the need for donor blood. In 15 patients we used an open venous reservoir consisting of a hard shell venous reservoir with an integrated cardiotomy filter. In another 15 patients we used a totally closed venous reservoir consisting of a collapsible venous reservoir, no coronary suction, modified vent and cell saver. Venous blood samples were collected pre, post and 24 hours postoperatively. Sex, age and perfusion times were identical in both groups. There were no statistically significant differences in concentrations of FXIIa and C3a, amount of blood loss and need for donor blood. Interleukin-6 and Elastase levels showed trends toward a lesser inflammatory reaction in closed venous reservoir patients. Modification of perfusion management with optimized air management does not seem to be an effective strategy in reducing the inflammatory response and influencing the coagulation system in this small cohort.
What Influences the Results in Critical Patients after Cardiovascular Surgery?
Authors: Ishikawa Susumu , Koyano Tetsuya , Takahashi Toru , Sato Yasushi , Hasegawa Yutaka , Ohki Satoshi , Oshima Kiyohiro , Oki Shigeru , Kunimoto Fumio , Morishita Yasuo
Published: May 2013

The predictive factors of surgical outcome were evaluated in compromised patients following cardiovascular surgery. Of 608 patients undergoing cardiovascular surgery between 1991 and 1999, 55 stayed in the intensive care unit for 2 weeks or longer. The mean age of these 55 patients was 56 years. There were 35 survivors and 20 nonsurvivors. Postoperative respiratory failure and gastrointestinal complications were significantly more frequent in those who died. The survival rate was significantly higher in patients who had enteral feeding compared to those who did not (88% versus 43%). Serum cholinesterase and total cholesterol concentrations were higher in the survivors. It was concluded that postoperative respiratory and gastrointestinal conditions influenced the surgical outcome, and serum cholinesterase and total cholesterol concentrations were valuable predictors of survival.