bluuebunny/crossref_metadata_2025_split huggingface dataset:
Microbial and Endotoxin Contamination in Water and Dialysate in the Central United States
Authors: Klein Elias , Pass Ted , Harding George B. , Wright Rita , Million Carolyn 
Published: July 2010

Abstract: The purified water supplies and randomly selected dialysates of 51 chronic and acute dialysis centers in the central United States were surveyed to assess the relative risks to dialysis patients from microbial and endotoxin contamination. A culture medium more sensitive than those generally employed in routine quality assurance assays was used for recovery of bacteria from water. With this medium, 35.3% of the water samples and 19% of the dialysate samples were out of compliance with the Association for the Advancement of Medical Instrumentation (AAMI) standards: 200 and 2,000 colony forming units (CFU)/ml, respectively. There was no correlation observed between the type of water purification system or the frequency of disinfection of the system and the bacterial and endotoxin contamination levels. There was also no correlation found between the bacterial and fungalCFU per ml and the endotoxin concentration per ml (EU/ ml). It is recommended that more sensitive culturing methods be used to provide adequate bacterial monitoring of dialysate center water supplies. Dialysis centers should monitor endotoxin in dialysate on a regular schedule and immediately after any endotoxemic‐like patient reactions. Yeast and fungi were observed in 10% and 64% of the water systems, respectively. Dialysate was contaminated by yeast and fungi in 30% and 70% of the centers, respectively. The concentrations of these microbes in both fluids were much lower than bacteria. However, they were observed often enough to warrant further investigation of their impact on the well‐being of dialysis patients.
Myointimal Hyperplasia: Pathogenesis and Implications. 2. Animal Injury Models and Mechanical Factors
Authors: Painter Thomas A. 
Published: July 2010

Abstract: Arterial wall injury either by balloon catheter, drying, or scraping results in a denudation of endothelial cells (EC) and a subsequent proliferation of smoothmuscle cells (SMC). The degree of SMC proliferation appears to be dependent on the degree of initial injury and not to the loss of the overlying endothelium. Successful reendothelialization of denuded areas depends on the size of the denuded segment as well as SMC–EC interactions. Prolonged exposure of SMC to serum substances results in inhibition of EC regrowth, the production of prostacyclin by SMC, and the development of a thromboresistant surface. Heparin appears to inhibit SMC proliferation in vivo (as well as in vitro), an effect that is independent of platelet SMC interaction. EC–derived heparin in vivo may also result in inhibition of SMC proliferation. Platelets may play an important role in the early response to arterial injury and development of myointimal hyperplasia (MIH), but their long–term role appears to be minor. Antiplatelet agents have widely varying species–dependenteffects on platelets and platelet–vessel wall interactions, but in specific circumstances they may inhibit MIH. The precise role of steroid drugs and immunosuppression on MIH in arterial injury models awaits further study. The role of lipoproteins in MIH is unclear; however, the inhibition of MIH by ±–3 fatty acids in vivo as well as their inhibition of platelet–derived growth factor production by EC in vitro implies a regulatory role. Acute hypertension results in a marked proliferation of EC and SMC in vivo and enhances the proliferative response to injury as well. Low wall shear stress, turbulence, and boundary layer separation all increase EC turnover, a likely influence on EC growth factor production. The compliance mismatch resulting from graft–artery anastomoses, injury, and endarterectomy results in locally increased cyclical stretch, which may predispose to SMC proliferation.
Regulation of Differentiation and Proliferation of Rat Hepatocytes by Lactose‐Carrying Polystyrene
Authors: Kobayashi A. , Goto M. , Sekine T. , Masumoto A. , Yamamoto N. , Kobayashi K. , Akaike T. 
Published: July 2010

Abstract: We noticed that hepatocytes recognize the structure of oligosaccharides via asialoglycoprotein receptors and synthesized lactose‐carrying styrene polymer (PVLA) as an asialoglycoprotein model. We found that the regulation of differentiated function and proliferation of hepatocytes that were cultured on polystyrene dishes can be achieved by varying the amount of PVLA coated on the dishes. The 3H‐thymidine uptake of cultured hepatocytes is low for cells cultured on dishes coated with high amounts of PVLA in which the hepatocytes are round and is highest for those cultured on dishes with a low PVLA coating level in which the hepatocytes are spread in shape.Moreover, bile acid release as a typical differentiated function of hepatocytes was maintained at higher levels in hepatocytes attached on dishes coated with a high level of PVLA. Our results indicated that regulation of differentiated function and proliferation in hepatocytes could be achieved by specific ligand‐mediated recognition of microscopic surface structure. Thus, it may be possible to regulate proliferation and differentiation of hepatocytes by design of the culturing substrata.
Mechanical Damage of Red Blood Cells by Rotary Blood Pumps: Selective Destruction of Aged Red Blood Cells and Subhemolytic Trauma
Authors: Sakota Daisuke , Sakamoto Ryuki , Sobajima Hideo , Yokoyama Naoyuki , Waguri Satoshi , Ohuchi Katsuhiro , Takatani Setsuo 
Published: July 2010

AbstractIn this study, mean cell volume (MCV), mean cell hemoglobin concentration (MCHC), and mean cell hemoglobin (MCH) were measured to quantify RBC damage by rotary blood pumps.Six‐hour hemolysis tests were conducted with a Bio‐pump BPX‐80, a Sarns 15200 roller pump, and a prototype mag‐lev centrifugal pump (MedTech Heart) using fresh porcine blood circulated at 5 L/min against a 100 mm Hg head pressure. The temperature of the test and noncirculated control blood was maintained at 37°C. The normalized index of hemolysis (NIH) of each pump was determined by measuring the plasma‐free hemoglobin level. The MCV was measured with a Coulter counter, and MCHC was derived from total hemoglobin and hematocrit. MCH was derived from MCV and MCHC.A multivariance statistical analysis (ANOVA) revealed statistically significant differences (n = 15, P < 0.05) in MCV, MCHC, and MCH between the blood sheared by the rotary blood pumps and the nonsheared control blood. Normalized to the control blood, the Bio‐pump BPX‐80 showed an MCV of 1.04 ± 0.03, an MCHC of 0.95 ± 0.04, and an MCH of 0.98 ± 0.02; the mag‐lev MedTech Heart had an MCV of 1.02 ± 0.02, an MCHC of 0.97 ± 0.02, and an MCH of 0.99 ± 0.01; and the roller pump exhibited an MCV of 1.03 ± 0.03, an MCHC of 0.96 ± 0.03, and an MCH of 0.99 ± 0.01. Per 0.01 increase in NIH, the BPX‐80 showed a normalized MCV change of +10.1% and a normalized MCHC change of −14.0%; the MedTech Heart demonstrated a +6.9% MCV and −9.5% MCHC change; and the roller pump had a +0.5% MCV and −0.6% MCHC change.Due to shear in the pump circuits, the RBC increased while the MCHC decreased. The likely mechanism is that older RBCs with smaller size and higher hemoglobin concentration were destroyed fast by the shear, leaving younger RBCs with larger size and lower hemoglobin concentration. Subhemolytic trauma caused the intracellular hemoglobin to decrease due to gradual hemoglobin leakage through the micropores formed in the thinned membrane.In conclusion, the rate of change in MCV and MCHC with respect to NIH change provides useful information relating to selective destruction of RBCs, while the MCH level reflects subhemolytic damage.
The Hemodynamic Behavior of Arterial Anastomosis Using Fibrin Sealant: Experimental Study in Swine
Authors: Rocha Eduardo A.V. , De Souza Cláudio 
Published: July 2010

AbstractThe wide use of biological sealants as a reinforcement for arterial sutures and the small experimental base in literature motivated this study. Our aim was to evaluate the flow, tear pressure, and the need of reinforcement stitches in sutured arteries after a cross‐section. This research project complied with the Helsinki convention. The Tissucol (Baxter) fibrin sealant was used in all experiments. The femoral and carotid arteries of 17 swine from the same breed (weighing from 15 to 20 kg) were cross‐sectioned after heparinization and subjected to anastomoses using a single continuous plane of 7‐0 prolene. We worked with 68 artery samples, 34 in the treatment group and 34 in the control group. For each animal, one carotid and one femoral artery randomly received fibrin sealant with the contralateral side being used as a control. The need and the number of reinforcement stitches were recorded. Ten minutes after protamine infusion, the animals were sacrificed and the arteries were catheterized respecting 1 cm proximal and distal. The arteries were measured and placed on a flow meter to evaluate the flow rate of 10 mL of 0.9% NaCl in a 50 cm high column. The arteries were then subjected to air infusion at increasingly higher pressures (stepwise increases of 25 mm Hg), the grafts were dipped in 0.9% NaCl solution, the first air leakage was observed, and the tear pressure recorded. Data was analyzed with EpiInfo 6 data manager. The external diameters and thickness of the arteries were similar in both the treatment and control group. There was no significant difference between the groups regarding the tear pressure (P = 0.329), flow rate (P = 0.943), and the number of samples with a tear pressure above 200 mm Hg. However, the sealant reduced the number of reinforcement stitches necessary (P =  0.029). We conclude that fibrin sealant reduces the need of additional stitches; however, it does not change the tear pressure nor significantly reduces the flow.
Nitric Oxide in Conjunction With Milrinone Better Stabilized Pulmonary Hemodynamics After Fontan Procedure
Authors: Cai Jiming , Su Zhaokang , Shi Zhenying , Zhou Yanping , Xu Zhiwei , Liu Jinfen , Chen Ling , Xu Zhuoming , Yu Xiaoqing , Ding Wenxiang , Yang Yanmin 
Published: July 2010

AbstractInhaled nitric oxide (iNO) has been used for patients with increased pulmonary vascular resistance (PVR) shortly after Fontan operation, but repeat deterioration of PVR during or shortly after its withdrawal remains a major concern. Milrinone, a phosphodiesterase type 3 (PDE3) inhibitor, can also reduce PVR for postoperative patients with pulmonary hypertension. We hypothesized that iNO, in conjunction with milrinone, can provide additive benefits for pulmonary hemodynamics and reduce the occurrence of iNO withdrawal failure/rebound. Thirty‐one patients with marked elevation of transpulmonary pressure gradient (TPG, >10 mm Hg) or central venous pressure (CVP, >15 mm Hg) after modified fenestrated Fontan operation were prospectively randomized into two groups, that is, group iNO (iNO at ∼10 ppm, n = 15) and group iNO + Mil (iNO at ∼10 ppm and milrinone at 0.5 µg/kg/min, n = 16). Hemodynamics, arterial blood oxygenation, and occurrence of withdrawal failure/rebound were compared between the two groups. Combined application of iNO and milrinone resulted in (i) more significant decrement of CVP (19.6 ± 3.5% in group iNO + Mil vs. 15.2 ± 4.6% in group iNO, P < 0.05) and TPG (18.2 ± 4.8% in group iNO + Mil vs. 15.3 ± 2.6% in group iNO, P < 0.05), (ii) more significant increment of systolic systemic arterial pressure (8.7 ± 2.7% in group iNO + Mil vs. 5.2 ± 3.1% in group iNO, P < 0.05), and (iii) more significant improvement of arterial oxygen saturation (9.3 ± 3.2% in group iNO + Mil vs. 6.8 ± 2.8% in group iNO, P < 0.01). Occurrence of iNO withdrawal failure during its weaning or rebound after its discontinuation was significantly lower in group iNO + Mil. The combined use of iNO and milrinone provided additive benefits as compared with exclusive use of iNO for patients with elevated PVR after Fontan procedure.
Optimal Positive End‐Expiratory Pressure During Pumpless Extracorporeal Lung Membrane Support
Authors: Jungebluth Philipp , Iglesias Manuela , Go Tetsuhiko , Sibila Oriol , Macchiarini Paolo 
Published: July 2010

AbstractThe aim of this study was to determine the optimal positive end‐expiratory pressure (PEEP) required during extracorporeal lung membrane support (interventional lung assist [iLA]; Novalung GmbH, Hechingen, Germany). Twenty healthy pigs were initially (4 h) mechanically ventilated with a tidal volume (VT) of 10 mL/Kg, respiratory rate (RR) of 20 breaths/min, PEEP of 5 cm H2O, and fraction of inspired O2 (FiO2) of 1.0. Thereafter, the iLAs were placed arteriovenously transfemorally and settings reduced to reach near static ventilation (VT ≤ 2 mL/Kg, RR 4 breaths/min, PEEP of 5, FiO2 1.0). Then, animals were assigned to four study groups evaluating 5 cm H2O increasing levels of PEEP for 8 h. Gas exchanges with PEEP ≤ 10 cm H2O were significantly worse than those with PEEP > 12 cm H2O, and this without hemodynamical imbalance. This study suggests that the iLA may provide adequate gas exchange during static ventilation only with PEEP levels > 10 cm H2O, and this without pulmonary or systemic hemodynamic imbalance.
Venous Pressure Regulation During Pulsatile Extracorporeal Life Support
Authors: Choi Seong Wook , Nam Kyoung Won 
Published: July 2010

AbstractDuring the use of pulsatile extracorporeal life support (pulsatile‐ECLS), the patient's venous pressure near the inlet venous catheter tip must be monitored to maintain sufficient blood flow and to prevent vein collapse. However, direct measurement of the venous pressure and the estimate of suction using measured blood inflow and prepump pressure are not practical because of setup difficulties during emergency treatments and in cardiovascular operations. In this article, we describe a new method for estimating the venous pressure that can be implemented in the controller of the pulsatile‐ECLS system, the T‐PLS. It uses real‐time measurement of the electric current and actuator motion. The current waveform of the T‐PLS is used to determine the outflow amount and the volume remaining in the pulsatile pumps. Previously measured values of the pulsatile‐ECLS compliance and the hemodynamic resistance along the inflow path are used to evaluate venous pressure with estimated blood flow. Estimated prepump pressure, inflow, and venous pressure were compared to the measured data in a series of in vitro experiments. The estimated venous pressure was used to avoid vein collapse and to increase the reliability in animal experiments.
Glutamate and astrocytes—Key players in human mesial temporal lobe epilepsy?
Authors: Eid Tore , Williamson Anne , Lee Tih‐Shih W , Petroff Ognen A , De Lanerolle Nihal C 
Published: July 2010

Summary Approximately one‐third of all patients with epilepsy continue to suffer from seizures even after appropriate treatment with antiepileptic drugs. Medically refractory epilepsies are associated with considerable morbidity and mortality, and more efficacious therapies against these disorders are clearly needed. However, the discovery of better therapies has been lagging due to an incomplete understanding of the mechanisms underlying the development of epilepsy (epileptogensis) and seizures (ictogenesis) in humans. An increasing number of studies have suggested that an abnormal amplification of glutamatergic activity—often referred to as the “glutamate hypothesis”—is involved in the pathophysiology of seizures and certain types of medically refractory epilepsies. For example, elevated levels of extracellular glutamate in hyperexcitable areas of the brain, up‐regulation of glutamate receptors, and loss of the glutamate‐metabolizing enzyme, glutamine synthetase (GS), have all been reported in patients with mesial temporal lobe epilepsy (MTLE). Moreover, it appears that glial cells, particularly the astrocyte, may play a key role in the glutamate overflow in MTLE. Proliferation of astrocytes is a hallmark of the epileptogenic focus in MTLE, and the proliferated cells are characterized by several unique features that are permissive for the excessive accumulation and release of astrocytic glutamate. Here, we assess recent data regarding the glutamate excess in epilepsy, review the role of glutamine synthetase, and discuss the implications of astrocytes in the pathophysiology of MTLE.
Irreversible Exocrine Pancreatic Insufficiency in Alcoholic Rats Without Chronic Pancreatitis After Alcohol Withdrawal
Authors: Li Jing , Zhou Chao , Wang Rui , Liu Rui , Huang Zhiyin , Tang Chengwei 
Published: July 2010

Background:  Long‐term alcohol consumption alone did not cause chronic pancreatitis (CP) but impaired exocrine pancreatic function. This study is to explore the reversibility of exocrine pancreatic insufficiency in the abstinent rats and its mechanism.Methods:  Forty‐eight healthy male Wistar rats were divided randomly into 4 groups: 6‐month control, 6‐month ethanol, 9‐month control, and 9‐month ethanol + withdrawal. Morphological changes of pancreatic acinar cells were observed. Pancreatic amylase and lipase were measured using an automatic biochemical analyzer. Free fatty acid (FFA) in rat intestinal chyme was measured. Cholecystokinin (CCK) levels were determined by radioimmunoassay. The expression of CCK‐A receptors was quantitatively analyzed by Western blot.Results:  Alcohol‐induced ultramicrostructure changes of pancreatic acinar cells, including lipid droplets, myelinoid inclusion bodies, dilated rough endoplasmic reticulums, and diminished zymogen granules, were not attenuated after alcohol abstinence. The outputs of amylase and lipase, FFA content in intestinal chyme, and the intestinal and the pancreatic CCK levels in rats were reduced after chronic alcohol intake and were still lower than the control after cessation of alcohol use. Chronic ethanol intake or abstinence did not induce any change in the expression of CCK‐A receptors.Conclusions:  Exocrine pancreatic insufficiency was irreversible in alcoholic rats without CP after alcohol withdrawal. It may be attributed to reduced pancreatic CCK, long‐standing fatty infiltration, ultramicrostructure injuries in pancreatic acinar cells, and aging.
Measurement of Serum, Liver, and Brain Cytokine Induction, Thiamine Levels, and Hepatopathology in Rats Exposed to a 4‐Day Alcohol Binge Protocol
Authors: Zahr Natalie M. , Luong Richard , Sullivan Edith V. , Pfefferbaum Adolf 
Published: July 2010

Background:  In rodent and human studies, ethanol (EtOH) exposure is associated with elevated brain levels of the magnetic resonance spectroscopy (MRS) signal representing choline‐containing compounds (Cho). One interpretation of elevated brain Cho is that it is a marker of neuroinflammation, and some evidence suggests that EtOH exposure promotes neuroinflammation. This study aimed to determine whether binge EtOH exposure (intragastric 3 g/kg 25% EtOH every 8 hours for 4 days) would induce the expression of certain cytokines in blood, liver, or brain, thereby supporting the neuroinflammation hypothesis of elevated Cho.Methods:  Ten of 18 wild‐type male Wistar rats (∼322 g at baseline) were exposed to EtOH and attained average blood alcohol levels of ∼315 mg/dl across 4 days. Blood for cytokine immunoassays was collected at baseline, after 5 doses of EtOH (binge), and immediately preceding euthanasia either 4 or 24 hours after the last dose of EtOH. Blood was additionally assayed for the levels of thiamine and liver enzymes; liver histopathology was performed postmortem; and tissue from liver and 6 brain regions was assayed for the potential induction of 7 cytokines.Results:  There were no group effects on the levels of thiamine or its phosphate derivatives, thiamine monophosphate or thiamine diphosphate. ANOVAs of liver enzyme levels indicated that only alkaline phosphatase (ALP) levels were higher in the EtOH group than in control group at binge; ALP elevations, however, are difficult to explain in the absence of changes in the levels of additional liver enzymes. Postmortem liver pathology provided evidence for minimal microvesicular lipidosis and portocentric fibrosis in the EtOH group. Group effects on the levels of the measured cytokines in the blood (TNF‐α, IFN‐γ, IL‐1β, IL‐4, IL‐5, IL‐13, and GRO/CXCL1) were not significant. Similarly, postmortem evaluation of liver cytokines did not reveal group effects. Postmortem evaluation of the 7 cytokines in 6 brain regions (anterior cerebellar vermis, cingulate cortex, frontal cortex, hippocampus, hypothalamus, striatum) also failed to identify group effects.Conclusions:  A single 4‐day bout of binge EtOH exposure alone was insufficient to induce the expression of 7 cytokines in blood, liver, or 6 brain regions of wild‐type Wistar rats. Alternative interpretations for elevations in brain Cho in response to a 4‐day binge EtOH treatment are therefore necessary and may include induction of cytokines not measured herein or other noninflammatory mechanisms.
Relationship between Cycle Length of Typical Atrial Flutter and Double Potential Interval after Achievement of Complete Isthmus Block
Authors: DEREJKO PAWEŁ , BODALSKI ROBERT , SZUMOWSKI ŁUKASZ J. , KOZŁOWSKI DARIUSZ , URBANEK PIOTR , ORCZYKOWSKI MICHAŁ , ZAKRZEWSKA‐KOPERSKA JOANNA , KĘPSKI ROMAN , CHOJNOWSKA LIDIA , POLAŃSKA MAGDALENA , SZUFLADOWICZ EWA , WÓJCIK ANNA , SACHER FRÉDÉRIC , HAÏSSAGUERRE MICHEL , WALCZAK FRANCISZEK 
Published: July 2010

Background:
There is some disagreement concerning the minimal value of the interval between components of double potentials (DPs interval) that allows distinguishing complete and incomplete block in the cavotricuspid isthmus (CTI).
Objectives:
To assess clinical utility of the relationship between atrial flutter cycle length (AFL CL) and the DPs interval.
Methods:
Ablation of the CTI was performed in 87 patients during AFL (245 ± 40 ms). Subsequently, DPs were recorded during proximal coronary sinus pacing at sites close to a gap in the ablation line and after achievement of complete isthmus block.
Results:
We noted strong correlation between AFL CL and the DPs interval after achievement of isthmus block (r = 0.73). The mean DPs interval was 95.3 ± 18.3 ms (range 60–136 ms) and 123.3 ± 24.3 ms (range 87–211 ms) during incomplete and complete isthmus block, respectively (P < 0.001). When expressed as a percentage of AFL CL, this interval was 35.7 ± 3.5% AFL CL (range 28–40.2%) and 50.4 ± 6.9% AFL CL (range 39–72%) during incomplete and complete isthmus block, respectively (P < 0.001). A cutoff value of 40% of AFL CL identified CTI block with 96.7% sensitivity and 100% specificity.
Conclusions:
The interval between DPs after achievement of block in the CTI correlates with AFL CL. The DPs interval expressed as a percentage of AFL CL allows better distinguishing between complete and incomplete isthmus block compared to standard method based on milliseconds. The DPs interval below 40% of AFL CL indicates sites close to a gap in the ablation line. (PACE 2010; 33:1518–1527)