bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of the epidemiology of acne vulgaris among Caucasian, Asian, Continental Indian and African American women
Authors: Perkins A.C. , Cheng C.E. , Hillebrand G.G. , Miyamoto K. , Kimball A.B. 
Published: November 2010

AbstractBackground  Acne vulgaris is a common skin disease with a large quality of life impact, characterized by comedones, inflammatory lesions, secondary dyspigmentation and scarring. There are few large objective studies comparing acne epidemiology between racial and ethnic groups.Objective  This study aimed to define the prevalence and subtypes of acne in women of different racial groups from four ethnicities.Methods  The sample consisted of 2895 (384 African American, 520 Asian, 1295 Caucasian, 258 Hispanic and 438 Continental Indian) women ranging in age from 10 to 70 years. Photographs of subjects were graded for acne lesions, scars, dyspigmentation, and measurements taken of sebum excretion and pore size.Results  Clinical acne was more prevalent in African American and Hispanic women (37%, 32% respectively) than in Continental Indian, Caucasian and Asian (23%, 24%, 30% respectively) women. All racial groups displayed equal prevalence of both subtypes of acne with the exception of Asians, for whom inflammatory acne was more prevalent than comedonal (20% vs. 10%) acne, and in Caucasians, for whom comedonal acne was more prevalent than inflammatory (14% vs. 10%) acne. Hyperpigmentation was more prevalent in African American and Hispanic (65%, 48% respectively) than in Asian, Continental Indian and Caucasian (18%, 10%, 25% respectively) women. Dyspigmentation and atrophic scarring were more common in African American and Hispanic women than in all other ethnicities. There was a negative correlation between pore size and skin lightness for all ethnicities. Sebum production was positively correlated with acne severity in African American, Asian and Hispanic women, and pore size was positively correlated with acne in African American, Asian and Continental Indian women, (for all above results, P < 0.05).Limitations  Only female participants were recruited. Data collection was restricted to four cities, with some ethnicities from single cities. Acne was evaluated only on the left side of the face and the two‐dimensional nature of photography may not capture all skin surface changes.Conclusion  Acne prevalence and sequelae were more common in those with darker skin types, suggesting that acne is a more heterogeneous condition than previously described and highlight the importance of skin‐colour tailored treatment.
Climbing fiber‐evoked Purkinje cell discharge reduces expression of GABAa receptor‐associated protein and decreases its interaction with GABAa receptors
Authors: Qian Zuyuan , Yakhnitsa Vadim , Barmack Neal H. 
Published: November 2010

J. Neurochem. (2011) 117, 197–208.AbstractSustained neuronal activity induces synaptic remodeling, in part, by altering gene expression. We have used a major climbing fiber pathway onto cerebellar Purkinje cells to investigate the effects of sustained climbing fiber‐evoked glutamatergic synaptic transmission on transcription, expression and phosphorylation of proteins related to the regulation of inhibitory GABAa receptor function. Binocular horizontal optokinetic stimulation was used to modulate climbing fiber signals to Purkinje cells in the flocculus and nodulus of rabbits and mice. Purkinje cells in the flocculus and nodulus ipsilateral to the eye stimulated in the Posterior→Anterior direction received increased climbing fiber activity. Purkinje cells in flocculus and nodulus ipsilateral to the eye stimulated in the Anterior→Posterior direction received decreased climbing fiber activity. We identified changes in levels of gene transcripts in floccular and nodular Purkinje cells with the technique of differential display RT‐PCR. Increased climbing fiber input reduced transcript levels and expression of GABA receptor‐associated protein (GABARAP). Using a protein ‘pull down’ technique, we showed that GABARAP interacts with serine phosphorylated GABAaγ2, gephyrin and β‐tubulin. Serine de‐phosphorylation of GABAaγ2 reduced association of GABARAP with GABAaγ2. Climbing fiber activity did not influence the expression of GABAaγ2. Rather, it decreased its serine phosphorylation. Climbing fiber discharge decreased both expression of GABARAP and serine phosphorylation of GABAaγ2. Consequently, climbing fiber activity may reduce the surface expression of GABAa receptors in Purkinje cells rendering Purkinje cells less susceptible to interneuronal GABAergic inhibition.
Evaluation of Capiox FX05 Oxygenator With an Integrated Arterial Filter on Trapping Gaseous Microemboli and Pressure Drop With Open and Closed Purge Line
Authors: Qiu Feng , Peng Sophia , Kunselman Allen , Ündar Akif 
Published: November 2010

AbstractGaseous microemboli (GME) remain a challenge for cardiopulmonary bypass (CPB) because there is a positive correlation between microemboli exposure during CPB and postoperative neurological injury. Thus, minimizing the number of GME delivered to pediatric patients undergoing CPB procedures would lead to better clinical outcomes. In this study, we used a simulated CPB model to evaluate the effectiveness of capturing GME and the degree of membrane pressure drop for a new membrane oxygenator, Capiox Baby FX05 (Terumo Corporation, Tokyo, Japan), which has an integrated arterial filter with open and closed purge line. We used identical components in this study as our clinical CPB circuit. Three emboli detection and classification quantifier transducers were placed at prepump, preoxygenator, and postoxygenator sites in the circuit. Two flow probes as well as three pressure transducers were placed upstream and downstream of the oxygenator. The system was primed with human blood titrated to 30% hematocrit with Lactated Ringer's solution. A bolus of air (1 mL) was injected in the prepump site under nonpulsatile perfusion mode at three flow rates (500, 750, and 1000 mL/min) and with the purge line either open or closed. Six trials were performed for each unique set‐up for a total of 36 trials. All trials were conducted at 35°C. The circuit pressure was kept constant at 100 mm Hg. Both the size and quantity of microemboli detected at postoxygenator site were recorded for 5 min postair injection. It was found that total counts of GME were significantly reduced with the purge line open when compared to keeping the purge line closed (P < 0.0001 at 1000 mL/min). At all flow rates, most of the GME were under 20 microns in size. In terms of microemboli greater than 40 microns, the counts were significantly higher with the purge line closed compared to keeping the purge line open at flow rates of 750 mL/min and 1000 mL/min (P < 0.01). At all flow rates, there is a tiny difference of less than 1 mm Hg in membrane pressure drop between keeping the purge line open and closed, which is due to the small arteriovenous (A‐V) shunt (P < 0.001). These results suggest that the integrated arterial filter of the Capiox FX05 oxygenator significantly improves the capturing of GME but has little impact on membrane pressure drop.
Ventricular Assist Device in Patients With Prosthetic Heart Valves
Authors: Mokashi Suyog A. , Schmitto Jan D. , Lee Lawrence S. , Rawn James D. , Bolman III R. Morton , Shekar Prem S. , Couper Gregory S. , Chen Frederick Y. 
Published: November 2010

AbstractVentricular assist device (VAD) support in patients with a prosthetic heart valve had previously been considered a relative contraindication due to an increased risk of thromboembolic complications. We report our clinical experience of VAD implantation in patients with prosthetic heart valves, including both mechanical and bioprosthetic valves. The clinical records of 133 consecutive patients who underwent VAD implantation at a single institution from January 2002 through June 2009 were retrospectively reviewed. Six of these patients had a prosthetic valve in place at the time of device implantation. Patient demographics, operative characteristics, and postoperative complications were reviewed. Of the six patients, four were male. The mean age was 57.8 years (range 35–66 years). The various prosthetic cardiac valves included a mechanical aortic valve (n = 2), a bioprosthetic aortic valve (n = 3), and a mechanical mitral valve (n = 1). The indications for VAD support included bridge to transplantation (n = 2), bridge to recovery (n = 1), and postcardiotomy ventricular failure (n = 3). Three patients underwent left ventricular assist device placement and three received a right ventricular assist device. Postoperatively, standard anticoagulation management began with a heparin infusion (if possible) followed by oral anticoagulation. The 30‐day mortality was 50% (3/6). The mean duration of support among survivors was 194.3 days (range 7–369 days) compared with 16.0 days (range 4–29 days) for nonsurvivors. Of the three survivors, two were successfully bridged to heart transplantation and one recovered native ventricular function. Among the three nonsurvivors, acute renal failure developed in each case, and two developed heparin‐induced thrombocytopenia. This study suggests that VAD placement in patients with a prosthethic heart valve, either mechanical or bioprosthetic, appears to be a reasonable option.
In Vitro Evaluation of Right Ventricular Outflow Tract Reconstruction With Bicuspid Valved Polytetrafluoroethylene Conduit
Authors: Dur Onur , Yoshida Masahiro , Manor Philip , Mayfield Alice , Wearden Peter D. , Morell Victor O. , Pekkan Kerem 
Published: November 2010

AbstractConduits available for right ventricular outflow tract (RVOT) reconstruction eventually become stenotic and/or insufficient due to calcification. In order to reduce the incidence of reoperations we have developed and used a bicuspid valved polytetrafluoroethylene (PTFE) conduit for the RVOT reconstruction. The purpose of this study is to investigate the hemodynamic performance of the new design using a pediatric in vitro right heart mock loop. PTFE conduit has been used for the complete biventricular repair of 20 patients (age 1.7 ± 6 years) with cyanotic congenital defects. To account for the large variability of conduit sizes, 14, 16, 22, and 24‐mm conduit sizes were evaluated using an in vitro flow loop comprised of a pulsatile pump with cardiac output (CO) of 1.2–3.2 L/min, bicuspid valved RVOT conduit, pulmonary artery, venous compartments, and the flow visualization setup. We recorded the diastolic valve leakage and pre‐ and post‐conduit pressures in static and pulsatile settings. In vitro valve function and overall hemodynamic performance was evaluated using high‐speed cameras and ultrasonic flow probes. Three‐dimensional flow fields for different in vivo conduit curvatures and inflow regimes were calculated by computational fluid dynamics (CFD) analysis to further aid the conduit design process. The average pressure drop over the valved conduits was 0.8 ± 1.7 mm Hg for the CO range tested. Typical values for regurgitant fraction, peak‐to‐peak pressure gradient, and effective office area were 23 ± 2.1%, 13 ± 2.4 mm Hg, and 1.56 ± 0.2 cm2, respectively. High‐speed videos captured the intact valve motion with asymmetrical valve opening during the systole. CFD simulations demonstrated the flow skewness toward the major curvature of the conduit based on the pulmonic curvature. In vitro evaluation of the bicuspid valved PTFE conduit coincides well with acceptable early clinical performance (mild insufficiency), with relatively low pressure drop, and intact valve motion independent from the conduit curvature, orientation or valve location, but at the expense of increased diastolic flow regurgitation. These findings benchmark the baseline performance of the bicuspid valved conduit and will be used for future designs to improve valve competency.
Filament Support Spindle for an Intravascular Cavopulmonary Assist Device
Authors: Throckmorton Amy L. , Kapadia Jugal Y. , Wittenschlaeger Thomas M. , Medina Tanisha J. , Hoang Hien Q. , Bhavsar Sonya S. 
Published: November 2010

AbstractWe are developing an intravascular axial flow blood pump to support adolescent and adult Fontan patients. To protect the blood vessel, this pump has an outer cage with radially arranged filaments and a newly designed spindle at the pump outlet. The outlet spindle is included to limit the axial movement of the rotor and to house bearings that support the rotor. This study evaluates the impact of the outlet spindle on pump performance using computational fluid dynamics (CFD) and experimental testing of a prototype configuration. We measured the pressure–flow performance of the prototype with a protective cage using a blood analog fluid. The pump with the cage filaments and spindle generated 1 to 16 mm Hg of pressure rise for flow rates of 1 to 4 L/min at 4000 to 7000 rpm. The difference between the CFD predictions and experimental results was found to be approximately 9.8%. Scalar stress levels remained below 570 Pa with exposure times on the order of 1.5 s. These results are acceptable and support the continued development of this cavopulmonary assist device with an outlet spindle to reinforce the protective cage filament design.
Extracorporeal Membrane Oxygenation Following Norwood Stage 1 Procedures at a Single Institution
Authors: Ugaki Shinya , Kasahara Shingo , Kotani Yasuhiro , Nakakura Mahito , Douguchi Takuma , Itoh Hideshi , Arai Sadahiko , Sano Shunji 
Published: November 2010

AbstractExtracorporeal membrane oxygenation (ECMO) is an important circulatory assist for children with refractory cardiopulmonary dysfunction, but its role and indications after a stage 1 Norwood procedure are controversial. We assessed outcomes and risk factors in patients who underwent a Norwood palliation and ECMO at our institution. We retrospectively reviewed all patients who underwent a Norwood procedure and were supported with ECMO between January 1998 and January 2010. Of the 91 children who underwent a Norwood procedure during the study period, there were 15 postoperative runs of ECMO in 12 patients. The diagnoses of the patients included five with hypoplastic left heart syndrome, five with a hypoplastic left heart syndrome variant, and two with critical aortic stenosis. A total of four patients underwent bilateral pulmonary artery banding, and two patients underwent aortic valvuloplasty before the stage 1 Norwood procedure. The mean age of the patients was 28 ± 30 days, and mean body weight was 2.6 ± 0.5 kg at the induction of ECMO. The indications for ECMO were low cardiac output in six children, circulatory collapse needing cardiopulmonary resuscitation in six children, and hypoxemia in three children. Five of the 12 patients were successfully weaned from ECMO. The significant risk factors for the inability to be weaned from ECMO were a history of circulatory collapse requiring cardiopulmonary resuscitation, and the induction of ECMO in the intensive care unit. Induction of ECMO may be considered earlier when hemodynamics are unstable in impaired patients following a stage 1 Norwood procedure to avoid circulatory collapse.
Pneumatic Pulsatile Ventricular Assist Device as a Bridge to Heart Transplantation in Pediatric Patients
Authors: Amodeo Antonio , Brancaccio Gianluca , Michielon Guido , Filippelli Sergio , Ricci Zaccaria , Morelli Stefano , Gagliardi Maria Giulia , Iacobelli Roberta , Pongiglione Giacomo , Di Donato Roberto M. 
Published: November 2010

AbstractDespite the remarkable advances with the use of ventricular assist devices (VAD) in adults, pneumatic pulsatile support in children is still limited. We report on our experience in the pediatric population. A retrospective review of 17 consecutive children offered mechanical support with Berlin Heart as a bridge to heart transplant from February 2002 to April 2010 was conducted. The median patient age was 3.9 years (75 days to 13.3 years). The median patient weight was 14.1 kg (2.9–43 kg). Before VAD implantation, all children were managed by multiple intravenous inotropes and mechanical ventilation (14) or extracorporeal membrane oxygenation (3). All patients had right ventricular dysfunction. Nine patients required biventricular mechanical support (BVAD), but in all other cases a single left ventricular assist device proved sufficient (47%). The median duration of VAD support was 47 days (1–168 days). The median pre‐VAD pulmonary vascular resistance index (Rpi) was 5.7 WU/m2 (3.5 to 14.4 WU/m2). Eleven patients (65%) were successfully bridged to heart transplantation after a median duration of mechanical support of 68 days (6–168 days). Six deaths occurred (35%), three for neurological complications, one for sepsis, and two others for device malfunctioning. Since 2007, the survival rate of our patients has increased from 43% to 80%, and the need for BVAD has decreased from 86% to 30%. In two patients with Rpi >10 WU/m2, unresponsive to pulmonary vasodilatator therapy, Rpi dropped to 2.2 and 2 WU/m2 after 40 and 23 days of BVAD support, respectively. Seven patients (41%) required at least one pump change. Of 11 patients undergoing heart transplant, four developed an extremely elevated (>60%) panel reactive antibody by enzyme‐linked immunosorbent assay, confirmed by Luminex. All of them experienced at least one acute episode of rejection in the first month after heart transplant, needing plasmapheresis. The survival rate after heart transplantation was 100% with a median follow‐up of 25.4 months (6 days to 7.7 years). Mechanical support in children with end‐stage heart failure is an effective strategy as a bridge to heart transplantation with a reasonable morbidity and mortality. BVAD support may offer an additional means to reverse extremely elevated pulmonary vascular resistance.
A Newly Developed Miniaturized Heart‐Lung Machine—Expression of Inflammation in a Small Animal Model
Authors: Schnoering Heike , Arens Jutta , Terrada Estella , Sachweh Joerg S. , Runge Maximilian , Schmitz‐Rode Thomas , Steinseifer Ulrich , Vazquez‐Jimenez Jaime F. 
Published: November 2010

AbstractCardiopulmonary bypass may cause severe inflammatory reactions and multiorgan failure, especially in premature and low‐weight infants. This is due in part to the large area of contact with extrinsic surfaces and the essential addition of foreign blood. Thus, we developed a new miniaturized heart‐lung machine (MiniHLM) with a total static priming volume of 102 mL (including arterial and venous lines) and tested it in a small animal model. Seven Chinchilla Bastard rabbits were perfused with the MiniHLM (dynamic priming volume 127 mL). Seven animals serving as a control were perfused using Dideco Kids and a Stöckert roller pump (modified dynamic priming volume 149 mL). The rabbits were anesthetized and sternotomized, followed by cannulation of the aorta and the right atrium. The aorta was clamped for 1 h. Blood for examination of inflammation (TNF‐α, IL‐1β, IL‐6, IL‐8, and IL‐10) and blood gas analysis were taken before skin incision, 5 min before opening of the aorta, 15 min after opening of the aorta, and 4 h after the initiation of cardiopulmonary bypass. The parameters of inflammation were expressed by means of the comparative CT method (ΔΔCT method). After gradual reduction of perfusion with the HLM, the heart was decannulated, and the sternum was closed. All rabbits were successfully weaned from cardiopulmonary bypass. Blood gas analysis was unremarkable in all cases. Foreign blood was not administered. Although statistical significance was not achieved, there was a reduced expression of inflammatory markers in the MiniHLM group. The newly developed MiniHLM prototype was tested successfully in a small animal model in terms of technical function and expression of inflammation. Upcoming tests with the industrially manufactured MiniHLM may reveal the advantages of the MiniHLM in comparison with the conventional HLM.
Extracorporeal Circulation for Rewarming in Drowning and Near‐Drowning Pediatric Patients
Authors: Coskun Kasim Oguz , Popov Aron Frederik , Schmitto Jan Dieter , Hinz José , Kriebel Thomas , Schoendube Friedrich Albert , Ruschewski Wolfgang , Tirilomis Theodor 
Published: November 2010

AbstractDrowning and near‐drowning is often associated with severe hypothermia requiring active core rewarming. We performed rewarming by cardiopulmonary bypass (CPB). Between 1987 and 2007, 13 children (9 boys and 4 girls) with accidental hypothermia were rewarmed by extracorporeal circulation (ECC) in our institution. The average age of the patients was 3.2 years. Resuscitation was started immediately upon the arrival of the rescue team and was continuously performed during the transportation. All patients were intubated and ventilated. Core temperature at admission ranged from 20 to 29°C (mean 25.3°C). Connection to the CPB was performed by thoracic (9 patients) or femoral/iliac means (4 patients). Restoration of circulation was achieved in 11 patients (84.6%). After CPB termination two patients needed an extracorporeal membrane oxygenation system due to severe pulmonary edema. Five patients were discharged from hospital after prolonged hospital stay. During follow‐up, two patients died (10 and 15 months, respectively) of pulmonary complications and one patient was lost to follow‐up. The two remaining survivors were without neurological deficit. Modes of rewarming, age, sex, rectal temperature, and serum electrolytes did not influence mortality. In conclusion, drowning and near‐drowning with severe hypothermia remains a challenging emergency. Rewarming by ECC provides efficient rewarming and full circulatory support. Although nearly half of the children may survive after rewarming by ECC, long‐term outcome is limited by pulmonary and neurological complications.
Improving Oxygenator Performance Using Computational Simulation and Flow Field‐Based Parameters
Authors: Graefe Roland , Borchardt Ralf , Arens Jutta , Schlanstein Peter , Schmitz‐Rode Thomas , Steinseifer Ulrich 
Published: November 2010

AbstractCurrent goals in the development of oxygenators are to reduce extrinsic surface contact area, thrombus formation, hemolysis, and priming volume. To achieve these goals and provide a favorable concentration gradient for the gas exchange throughout the fiber bundle, this study attempts to find an optimized inlet and outlet port geometry to guide the flow of a hexagonal‐shaped oxygenator currently under development. Parameters derived from numerical flow simulations allowed an automated quantitative evaluation of geometry changes of flow distribution plates. This led to a practical assessment of the quality of the flow. The results were validated qualitatively by comparison to flow visualization results. Two parameters were investigated, the first based on the velocity distribution and the second calculated from the residence time of massless particles representing erythrocytes. Both approaches showed significant potential to improve the flow pattern in the fiber bundle, based on one of the parameters of up to 66%. Computational fluid dynamics combined with a parameterization proved to be a powerful tool to quickly improve oxygenator designs.