bluuebunny/crossref_metadata_2025_split huggingface dataset:
Variants within protectin (CD59) and CD44 genes linked to an inherited haplotype in a family with coeliac disease
Authors: Vidal C. , Borg J. , Xuereb‐Anastasi A. , Scerri C. A. 
Published: January 2009

AbstractCoeliac disease (CD) is an autoimmune disorder characterised by inflammation, villous atrophy and hyperplasia of the small intestinal mucosa that affects genetically susceptible individuals. A genome‐wide scan was performed in 17 family members with high incidence of CD. Highest nonparametric linkage (NPL) and logarithm of odds (LOD) scores were of 6.21 (P = 0.0107) and 2.57, respectively, to a region on chromosome 11p13‐12. Following fine mapping, NPL and LOD scores did not change, but the linkage interval on chromosome 11 was narrowed to a region that is approximately 50.94 cM from pTer. Two inherited haplotypes on chromosomes 11p13‐12 and 9q21 were observed in all affected members but not in the majority of clinically normal individuals. Sequencing of genes at region 11p13‐12 showed a number of sequence variants, two of which were linked with the inherited haplotype. One of these variants in the CD59 gene was found at a very low frequency in the population and could possibly affect pre‐messenger RNA splicing. This study is of particular importance for the identification of novel genes that might be responsible for CD other than human leukocyte antigen.
Blood Level of Marcaine® (LAC‐43) in Axillary Plexus Blocks, Intercostal Nerve Blocks and Epidural Anaesthesia
Authors: Yoshikawa K. , Mima T. , Egawa J. 
Published: January 2009

SUMMARYThe blood concentration of Marcaine® after axillary nerve blocks, intercostal nerve blocks and lumbar epidural anaesthesia was determined in man.The blood concentration remained low when Marcaine was injected with adrenaline. Slow onset and long duration of anaesthesia coincided well with a slow increase to peak concentration, low peak concentration and slow decrease thereafter.ZUSAMMENFASSUNGNach der Vornahme von Nervblockaden, axillar und intercostal, sowie lumbalen Epiduralanaesthesien wurde die Blutkonzentration von Marcain beim Menschen bestimmt. Wenn Marcain gemeinsam mit Adrenalin injiziert worden war, blieb der Blutspiegel niedrig. Langsamer Wirkungseintritt und lange Dauer der Anaesthesie waren in guter Übereinstimmung mit dem lang‐samen Anstieg zur Höchstkonzentration, der niedrigen Höchstkonzentration und dem langsamen anschliessenden Abfall derselben.
Arterial Oxygen Tensions Preceding Surgery in Patients With Cardiovascular or Pulmonary Disease
Authors: Martinez Leonardo R. , Norlander Olof P. 
Published: January 2009

SUMMARYArterial oxygen tensions (PaO2) were measured pre‐operatively in 66 patients awaiting elective major intrathoracic or peripheral vascular surgery.A wide range of (PaO2) levels was found within the group, and this was attributed to the direct influence of the age and physical status of the patients. The means of the values obtained were 80 mm Hg in patients of 45 years or under, and 74 mm Hg in those over 45 years of age. Equations of the lines were drawn to show the relationship between age and (PaO2) levels in the two groups.We feel that it is possible to establish more realistic “normal” pre‐operative (PaO2) levels in patients in hospital awaiting surgery if careful attention is paid to the assignment of the subjects to groups according to their age and state of health.ZUSAMMENFASSUNGDer arterielle Sauerstoffdruck (PaO2) wurde präoperativ bei 66 Patienten vor grösseren elektiven intrathorakalen oder peripheren Gefässoperationen bestimmt.Die gefundenen Werte zeigten eine weite Streuung innerhalb der Gruppe, was auf den direkten Einfluss des Alters und des körperlichen Zustandes der Patienten zurückgeführt wurde. Bei den Patienten von 45 Jahren oder weninger lagen die Mittelwerte bei 80 mm Hg, bei denen oderhalb des 45. Lebensjahres bei 74 mm Hg. Es konnten lineare Gleichungen aufgestellt werden, die die Abhängigkeit zwischen Alter und Sauerstoffdruck in den beiden Gruppen zeigten.Wir glauben, dass es möglich ware, etwas realistischere «normale» präoperative PaO2‐Werte für Patienten aufzustellen, die einer Operation entgegensehen, wenn darauf geachtet wird, dass die betreffenden Personen entsprechend ihrem Alter und Gesundheitszustand eingeordnet werden.
The Cardiovascular Effect of Propanidid (Epontol®)
Authors: Bernhoff Albert 
Published: January 2009

SUMMARYThe cardiovascular effect of the new ultrashort‐acting nonbarbituric intravenous anaesthetic agent propanidid (Epontol®) was investigated and compared with anaesthetically equipotent doses of methohexital (Brietal®) in open‐chest rabbits under pentobarbital anaesthesia. With the doses used, propanidid had a more distinct effect on myocardial contractile force, blood pressure and right atrial pressure than methohexital. The differences were statistically significant.ZUSAMMENFASSUNGDie kardiovaskulären Wirkungen des neuen ultrakurzwirkenden intravenösen Anaesthetikums Propanidid (Epontol) wurden untersucht und mit gleich stark wirkenden Dosen von Methohexital an Kaninchen mit offenem Thorax unter Pentobarbitalanaesthesie verglichen. In den angewandten Dosierungen hatte Propanidid einen deutlichen Effekt auf die Kontraktionskraft des Myocards, den Blutdruck und den rechten Vorhofsdruck gegenüber Methohexital. Die Unterschiede waren statistisch signifikant.
Influence of Changes in Arterial PCO2 on Cerebral Blood Flow and Cerebral Energy State during Hypothermia in the Rat
Authors: Hägerdal Magnus , Harp James R. , Siesjö Bo K. 
Published: January 2009

In order to study the relationship between arterial PCO2 and cerebral blood flow (CBF) in hypothermia, the body temperature of artificially ventilated rats was decreased to 22d̀C, and changes in CBF were evaluated from arteriovenous differences in oxygen content (AVDO2) at PaCO2 values of 15, 30, 40 and 60 mm Hg. The results were compared to those obtained at normal body temperature (37d̀C) over the PaCO2 range 15–60 mm Hg. Separate experiments were performed to evaluate CBF and CMRO2 at 22d̀C and a PaCO2 of 15 mm Hg, using an inert gas technique for CBF. The tissue contents of phosphocreatine, ATP, ADP, AMP and lactate were measured in hypothermic animals at Paco2values of 15, 30 and 60 mm Hg.The results showed that changes in CBF were of the same relative magnitude in hypothermia and normothermia when Paco2 was increased from about 35 to about 60 mm Hg. However, with a decrease in PaCO2 the reduction in CBF was much more pronounced in hypothermia, and at PaCO2 15 mm Hg CBF was less than 20 % of the value measured in normothermic and normocapnic animals. The results of the metabolite measurements gave no evidence of tissue hypoxia in spite of the pronounced reduction in CBF. Although the results demonstrate that the brain of a hypothermic animal is protected against the harmful effects of a lowered CBF, it may not warrant recommending hyperventilation in clinical cases of hypothermia, especially not in patients with arteriosclerosis or cerebrovascular diseases.
The Influence of the Internal Compliance of a Respirator on the Alveolar Gas Distribution
Authors: Meier Amadeo , Baum Marcel 
Published: January 2009

The occurrence of intrapulmonary redistribution “pendelfult” during the plateau phase of a respirator, with and without internal compliance, was studied in a lung‐model which simulated an obstructive inhomogeneity. Internal compliance was achieved by adding a flask, with a variable volume, to the patient circuit of a respirator which had a low compressible volume (Engström Care System ECS 2000, Jungner Instrument AB, Sweden). The amount of redistributed volume was found to be dependent upon the internal compliance. Without additional compressible volume, the ventilator produced up to 18 % redistribution, which under all conditions could be brought below the 1 % level when an internal compliance was introduced. A highly significant correlation between the amount of redistributed volume (pendelluft) and the discharge time‐constant of the plateau (rpl = C1 (RI + Rtr) could be established.The results of mathematical considerations gained from an electrical analogue coincided with our experimental findings. From this, some consequences could be derived for the design of an internal compliance for use with a respirator.
Influence of Enflurane on Cerebral Blood Flow in Man
Authors: Rolly G. , Aken J. Van 
Published: January 2009

Cerebral blood flow was measured by means of a 10‐channel cerebrograph in anesthe‐tised patients before and during 2% enfluranc. This investigation was carried out after carotid angiography; 2 3 mCi Xe133 was injected into the internal carotid artery. The clearance curves of Xel33 were captured by 10 scintillation counters. In addition to regional cerebral blood flow (rCBF), arterial blood pressure, heart rate, stroke volume, cardiac output and arterial blood gases were measured in seven adult patients.During 2% enflurane, a small, and in two regions a significant decrease in rCBF was observed. Mean arterial pressure and heart rate decreased significantly, but cardiac output did not. The decrease in PaCo2 was not significant.
Hypertonic saline and dextran in normovolaemic and hypovolaemic healthy volunteers increases interstitial and intravascular fluid volumes
Authors: Tølløfsrud S. , Tønnessen T. , Skraastad ø. , Noddeland H. 
Published: January 2009

Background: Hypertonic saline (HS) is increasingly used for fluid resuscitation in hypovolaemic patients. Although the effects of HS have been investigated in animal models, controlled studies in healthy human individuals are few. Aim: The effects of iv. hypertonic saline 75 mg . ml‐1 in dextran 70, 60 mg . ml‐1 (HSD) infusion on fluid shifts between the interstitial and intravascular fluid spaces, diuresis and haemodynamics were studied in normovolaemic and moderately hypovolaemic healthy volunteers.Material and methods: Nine fasting subjects received 4 ml . kg‐1 HSD as a 10‐min infusion in a normovolaemic situation. Seven days later they served as their own controls in a hypovolaemic situation after 10% of the calculated blood volume had been withdrawn during a 15‐min period. Before and after the HSD infusion, interstitial colloid osmotic pressure (COPi) and interstitial fluid hydrostatic pressure (Pi) were measured on the lateral part of the thorax. During the study, blood sampling and pressure measurements were performed through a radial artery cannula, and central venous pressure measured through a catheter in the cubital vein.Results: In these awake and normovolaemic healthy volunteers, HSD infusion caused a transitory unpleasant sensation of headache and heat in the thorax up to the throat. A transitory haemodynamic effect was found with increased heart rate (HR), increased mean arterial pressure (MAP) from 77 ± 5 mmHg to 92 ± 13 mmHg (P<0.05) and CVP increase from 5 ± 1 mmHg to 8 ± 1 mmHg (P<0.05) after end of infusion. A haemodilution with increase in calculated blood volume lasting longer than the MAP increase was observed, with decreased COPi from 14.4 ± 2.2 mmHg to 12.1 ± 2.0 mmHg (P<0.05). The diuresis measured at 180 min was higher in the normovolaemic than in the hypovolaemic situation. More pronounced effects of the infused fluid (HSD) on calculated blood volume, interstitial compartment and CVP were observed during moderate hypovolaemia.Conclusions: HSD infusion resulted in increased calculated blood volume with increased HR, MAP, and CVP. These effects were greater in a hypovolaemic situation. The haemodilution was most likely caused by fluid shifts from the intracellular compartment to the interstitial and vascular fluid spaces, eventually increasing diuresis.
Perioperative transoesophageal echocardiography with low‐dose dobutamine stress for evaluation of myocardial viability: a feasible approach?
Authors: Palmgren I. , HultmanM.D J. , Houltz E. 
Published: January 2009

Background: The feasibility of low‐dose dobutamine stress combined with transoesophageal echocardiography (TEE) to detect viable left ventricular myocardium was evaluated in 22 anaesthetised patients prior to sternotomy for elective coronary artery bypass grafting (CABG).Methods:After baseline measurements, a dobutamine infusion beginning with 5 μg . kg‐1 . min‐1 was started and eventually increased to 10 μg . kg‐1 . min‐1. Viability was assessed as visual improvement of left ventricular wall motion (LVWM). The criteria for discontinuation of the infusion were: 1. any changes in LVWM, 2. an increase in preanaesthetic blood pressure exceeding 40 MMHg, and/or a >20% increase in preanaesthetic heart rate compared to preanaesthetic levels. An off‐line evaluation of LVWM was based upon visualisation of the left ventricle in a transgastric short‐axis mid‐papillary (mid‐P) view, and the left ventricle was divided into anterior, septal, inferior, and lateral segments. Moreover, an off‐line semiautomatic analysing system was used for assessing regional and global LVWM. With this analysis the effects on LVWM from changes in preload and afterload could be addressed.Results: 19 patients showed a decreased LVWM in one or several segments at baseline. A total of 36 segments exhibited decreased LVWM (an average of 1.9 segments/patient). Of these, 22 segments (61%) improved with dobutamine, while 12 segments (33%) did not, and 2 (6%) became more dysfunctional. Another 6 segments with normal motion at baseline became dysfunctional with dobutamine. According to the off‐line semiautomatic analysing system for LVWM, there were no statistically significant changes with dobutamine stimulation. Only one patient showed an increased postoperative aspartateamino‐transferase (ASAT) value (3.0 mmol . 1‐1) but no ECG changes.Conclusion: Since we regard the visual assessment of LVWM as being more applicable for this protocol than the semiautomatic analysis, we conclude that low‐dose dobutamine stress echocardiography seems to be a feasible method for detecting viable myocardium in the anaesthetised patient scheduled for elective CABG surgery. However, the semiautomatic analysis complemented our findings, since the variations in pre‐ and afterload did not significantly change the size of the left ventricle, which hereby would imply LVWM changes.
Intubation difficulties in patients with rheumatoid arthritis
Authors: Hakala .P. , Randell T. 
Published: January 2009

Background: Fibreoptic intubation has been suggested to be the best method to manage a compromised airway. This retrospective study was designed to compare endotracheal intubation with the help of a rigid laryngoscope or a fibrescope in patients with rheumatoid arthritis.Methods: Intubation difficulties with the laryngoscope and the fibrescope in patients with rheumatoid arthritis were investigated during a period of five and a half years. The anaesthesia records were used for analysis. The patients were divided into two groups (group I with 41 patients and group II with 37 patients) reflecting the change in the routine airway management in patients with rheumatoid arthritis in our hospital from the beginning of 1993. Before that time the patients were usually intubated orotracheally under general anaesthesia, but since 1993 rheumatoid patients with anticipated difficulties in endotracheal intubation have been preferably intubated fibreoptically awake under sedation and topical anaesthesia with a fibrescope.Results: Major difficulties in endotracheal intubations were encountered in 13% of patients in group I and in 8% in group II. On two occasions in group I tracheostomy was needed. In one of these patients, emergency tracheostomy was performed. In the latter group, the main reason for prolonged fibreoptic intubations was lack of experience.Conclusion: The introduction of fibreoptic intubation technique has had a favourable influence on the safety in the airway management of surgical patients with rheumatoid arthritis.
Comparison of subhypnotic doses of thiopentone vs propofol on the incidence of postoperative nausea and vomiting following middle ear surgery
Authors: Honkavaara P. , Saarnivaara L. 
Published: January 2009

Background: Middle ear surgery is associated with a high incidence of emetic sequelae and propofol has been reported to have antiemetic activity in subhypnotic doses.Methods: In a double‐blind, randomized study, the patients received either thiopentone 1.0 mg.kg‐1 (n=26) or 0.5 mg.kg‐1 propofol (n=26) at the end of middle ear surgery under isoflurane‐N2O‐fentanyl‐vecuronium anaesthesia. Trained nurses, unaware of the group assignment, assessed postoperative nausea, retching and vomiting up to 24 h after the end of anaesthesia. Droperidol 10μg.kg‐1 was used as a “rescue” antiemetic.Results: The main result was that the patients in the propofol group did not suffer from retching and vomiting (R&V) during the first 6 h, whereas these symptoms occurred in 46% (P<0.001) of the patients in the thiopentone group. The patients in the propofol group needed significantly less droperidol during the first 24 h (mean number of doses 0.39 ± 0.57 (SD)) than the patients in the thiopentone group (1.35 ± 1.47, P<0.005). Treatment with propofol was a predictor for lowered incidence of R&V, as well as male gender and negative history of motion sickness.Conclusion: Propofol at a subhypnotic dose of 0.5 mg.kg‐1 provides prophylaxis against retching and vomiting for the first 6 h postoperatively after middle ear surgery. The incidence of nausea was not reduced by propofol.
Intravenous fluid and postoperative nausea and vomiting after day‐case termination of pregnancy
Authors: Elhakim Dr.M. , El‐Sebiae S. , Kaschef N. , Essawi G. H. 
Published: January 2009

Background: Deprivation of oral fluid before minor surgery has been alleged to cause postoperative nausea. We examined the effect of intraoperative fluid load on postoperative nausea and vomiting over 3 d after day‐case termination of pregnancy.Methods: In a randomized study, 100 patients were allocated into one of two groups; receiving 1000 ml of compound sodium lactate solution during surgery or no intraoperative fluid. Propofol and alfentanil was used to induce and maintain anaesthesia with nitrous oxide (67%) and oxygen (33%). Visual analogue scores for nausea and pain, the time and frequency of emetic episodes, analgesic and antiemetic consumption were recorded for 3 d postoperatively.Results: The scores of nausea were significantly lower in the fluid group (P<0.05) compared with the control group at 1, 2, 4 h and during 24–48 h following surgery. The incidence of emesis was lower (P<0.01) after discharge, and the time to first oral fluid was shorter (P<0.05) in the fluid group. There was no difference in pain score or analgesic consumption between the groups. Five patients (10%) in the control group requested antiemetic medication compared with none in the fluid group.Conclusion: Intraoperative fluid administration may offer some benefit in decreasing the incidence of postoperative nausea and vomiting following day‐case surgery.
Limiting life support
Authors: Sjökvist P. , Sundin P.‐O. , Berggren L. 
Published: January 2009

Background: Different aspects of withholding or withdrawal of life‐sustaining treatment have been described in the literature. However, there are few descriptions of local policies or protocols regarding the limiting of life support. The present study describes the pattern of limiting life support in a Scandinavian intensive care unit (ICU) and the experience with a special protocol for such decisions.Method: Prospective study of decisions to limit life support in the ICU of a tertiary referral hospital during 1 year using a special protocol and medical records.Results: A decision to limit life support was documented in the special protocol in 61/1008 (6%) of the patients and in 39/79 (49%) of the patients dying in the ICU. Poor prognosis and failure to respond to treatment were the most common reasons for foregoing life‐sustaining treatment. Of the 61 patients with a special protocol, 7 survived more than 3 months. The decision was altered for 5 patients towards additional limitations and for 4 patients towards fewer or no limitations.Conclusion: Decisions to limit life support in the ICU are common. There is a substantial survival rate. A structured clinical protocol can be used for continuous follow‐up of decisions and the decision‐making process.
Detrimental effect of a non‐selective nitric oxide synthase inhibitor on the energy state of the liver following acute endotoxemia in rabbits
Authors: Kaneda K. , Makita K. , Yokoyama K. , Toyooka H. , Amaha K. 
Published: January 2009

Background: The effect of nitric oxide synthase (NOS) inhibitors in septic shock is very controversial. It is known that the administration of NOS inhibitors to normal subjects itself increases pulmonary vascular resistance with a concomitant decrease of cardiac output. Therefore, the hypothesis was tested that the detrimental effects of a non‐selective NOS inhibitor on liver energetics in a rodent model of endotoxemia are mediated by the adverse pulmonary circulatory effect of the drug itself.Methods: Twenty anesthetized rabbits were instrumented and two separate experiments (a magnetic resonance spectroscopic study and a hemodynamic study) were performed under similar conditions. Animals were assigned randomly to either a control group (group 1; animals received lipopolysaccharide (LPS) at a dose of 400 μg/kg alone) or a treatment group (group 2; animals received NG‐nitro‐L‐arginine methyl ester (L‐NAME) at a dose of 7.5 mg/kg, 75 min after administration of LPS).Results: In group 1, slight decreases in hepatic adenosine triphosphate (ATP) value were observed. In group 2, the decreases in ATP values were more prominent than those observed in group 1. LPS produced an acute drop in mean arterial pressure (MAP) with a concomitant increase in pulmonary vascular resistance (PVR) and a reduction in the cardiac output (CO) at 30 min after LPS. The administration of L‐NAME caused a transient increase in MAP with a concomitant increase in systemic vascular resistance at 2 h after LPS. However, these changes in PVR and CO were more prominent than in group 1.Conclusion: These results suggest that alterations within the pulmonary circulation may be a contributing factor which was responsible for the non‐selective NOS inhibitor‐induced acute hepatic energy derangement after LPS.
Retinyl palmitate injections reduce serum levels and effects of endotoxin on systemic haemodynamics and oxygen transport in the pig
Authors: Eriksson M. , Modig J. , Larsson A. , Rollman O. , Eriksson Ö. 
Published: January 2009

Background: Retinyl palmitate [(RP) 230 IU · kg‐1] modulates the circulatory and respiratory responses of a subsequent infusion of endotoxin in the pig. The aims of this study were: I. To determine if RP (2300 IU · kg‐1) affects the serum endotoxin levels in this model. II. To evaluate the effect of this dose of RP on circulatory and respiratory variables in our porcine model. III. To investigate the levels of RP and neutrophil count in porcine endotoxaemia.Methods: Ten anaesthetized pigs were randomly given 2300 IU · kg‐1 of RP or the solvent i.m. prior to the continuous i.v. infusion of E. coli endotoxin (10 μg · kg‐1 · h‐1). Another 4 sham animals were given either i.m. RP (n=2) or i.m. solvent (n=2) followed by an infusion of saline. Haemodynamics and oxygen extraction were monitored and samples taken for analysis of endotoxin, RP and blood cells.Results: I. Endotoxin levels in serum were lower (P<0.001) in the RP‐pretreated pigs. II. These animals had higher cardiac index (P<0.05), mean arterial pressure and left ventricular stroke work index (both P<0.001), and lower oxygen extraction (P<0.01). III. RP‐Pre=pretreatmert caused a paradoxical decrease in serum retinyl (P<0.001) and a more rapid restitution of neutrophil count (P<0.05).Conclusion: Pretreatment with RP (2300 IU · kg‐1) counteracts the progressive increase in serum endotoxin levels in porcine endotoxaemia.