bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dynamic bubble trap can replace an arterial filter during cardiopulmonary bypass surgery
Authors: Göritz Stefan , Schelkle Helmut , Rein Joachim-Gerd , Urbanek Simon 
Published: January 2007

Objective: The arterial filter (AF) and the dynamic bubble trap (DBT) reduce the number of air microbubbles passing through these devices. The aim of the study was to confirm that the DBT diminishes microbubbles in the arterial line similar to, or better than, the AF, and can replace it. Methods: In a clinical study, we evaluated 60 patients undergoing cardiopulmonary bypass surgery, divided into two groups (30 patients each). In the first group, we used an open extracorporeal system, and in the second group, a closed system. For 15 patients in each group, the AF was incorporated, the other 15 patients received the DBT. The microbubbles were counted before and after the AF or DBT, using two-channel-ultrasonic Doppler devices. Results: The exposure of patients to small bubbles (<45μm) is significantly higher in the AF than in the DBT group. The DBT reduces large bubbles (<45μm) better than the AF, with a rate exceeding 16%. Conclusion: The use of the DBT instead of the AF yields higher air micro-bubble removal efficacy, allowing replacement of the AF, assuming the AF is used for air removal purpose only.
Cerebral oxygen saturation changes during modified ultrafiltration
Authors: Medlin William M , Sistino Joseph J 
Published: January 2007

Background: A number of adverse effects are associated with the use of cardiopulmonary bypass (CPB) in pediatric patients undergoing cardiac surgery. Pulmonary compliance and gas exchange are decreased, and myocardial edema may result in diastolic dysfunction. Modified ultrafiltration (MUF) after CPB in children decreases body water, removes inflammatory mediators, improves hemodynamics, and decreases transfusion requirements. Purpose: To determine the factors that influence cerebral tissue oxygenation during MUF. Pediatric patients received the usual treatment, with MUF times from 10 to 19 min, as determined by circuit volume and patient hemodynamic stability. Results: Preliminary results in five patients with arterial saturation >95% during MUF demonstrates four predictors of cerebral oxygenation, using stepwise multiple linear regression with cerebral oxygen saturation as the dependant variable. In order of significance, they are pCO2, ultrafiltration flow rate, mean arterial pressure, and hematocrit. Conclusions: The results of this study will be used to determine the optimal performance of MUF. Maximizing cerebral oxygen delivery during this early post-bypass period is extremely important, and identifying the factors responsible for increased cerebral oxygen delivery during MUF allows the clinician to make the appropriate changes necessary to achieve this.
Vacuum-assisted venous drainage in extrathoracic cardiopulmonary bypass management during minimally invasive cardiac surgery
Authors: Colangelo Nicola , Torracca Lucia , Lapenna Elisabetta , Moriggia Stefano , Crescenzi Giuseppe , Alfieri Ottavio 
Published: January 2007

The diffusion of minimally invasive cardiac surgery (MICS) during open-heart surgery has increased the use of assisted venous drainage support for cardiopulmonary bypass (CPB). Peripheral cannulation with small cannulae and vacuum-assisted venous drainage (VAVD) during MICS has been adopted in our institution since 1998. After the Heartport technique (HP) experience, the trans-thoracic clamp technique is now currently used. The aim of this study is to report our experience with extrathoracic CPB with VAVD application (on CPB) during open-heart MICS. From October 1999 to June 2006, 193 patients underwent MICS. Thirty-seven (19.2%) patients were treated with the HP - 13 (35%) with robotic technology and 156 (80.8%) with trans-thoracic aortic clamping (TTAC). Mean age was 39 years (range: 12-77), and 114 patients (59.1%) were female. A total of 128 patients (66.3%) underwent mitral valve surgery, 57 (29.6%) atrial septal defect closure, five (2.6%) cardiac mass removal, and three (1.5%) tricuspid valve repair. Four patients (2.0%) had a previous cardiac procedure. Peripheral CPB was established with a standard coated circuit. A 14 Fr arterial cannula was inserted into the right jugular vein and positioned at the atrial/superior vena cava junction. A 21 or 28 percutaneous femoral cannula, depending on body surface area, was inserted in the femoral vein and an arterial cannula in the right femoral artery. Gravitational drainage was combined with VAVD. To improve the safety and effectiveness of this technique, we monitored the pressure on each venous cannula and in the reservoir. The mean CPB time was 74.8∓30 min (TTAC) and 119∓48 min (HP); mean aortic clamping time was 51∓19 min (TTAC) and 73∓29 min (HP). We did not record any neurological complication. Two patients (1.0%), one from each group, were converted to sternotomy. Three patients (1.5%) underwent re-exploration for bleeding. In-hospital mortality was 0.5% (N = 1) (HP). Mechanical ventilation time and intensive care unit stay were comparable to those recorded with conventional sternotomy. In conclusion, we found that extrathoracic CPB and VAVD during trans-thoracic clamping is a safe, simple, and effective technique for MICS. However, there is a potential risk of haemolysis and air embolism, which can be prevented with vacuum monitoring, and with the addition of gravitational drainage to reduce vacuum pressure.
Hydrodynamic performance and heat generation by centrifugal pumps
Authors: Ganushchak Y , van Marken Lichtenbelt W , van der Nagel T , de Jong D S 
Published: January 2007

For over a century, centrifugal pumps (CP) have been used in various applications, from large industrial pumps to flow pumps for aquariums. However, the use of CP as blood pumps has a rather short history. Consequently, the hydraulic performance data for a blood CP are limited. The aim of our investigation was to study the hydraulic performance and the heat generation of three commercially available CP: Bio-Medicus Bio-Pump BP80 (Medtronic), Rotaflow (Jostra Medizintechnik), and DeltaStreamTM DP2 (MEDOS Medizintechnik AQ). The study was performed using a circuit primed with a water-glycerin mixture with a dynamic viscosity of 0.00272 pa/s. Pressure-flow curves were obtained by a stepwise stagnation of the pump outlet or inlet. The temperature changes were observed using ThermaCAM SC2000 (Flir Systems). The pumps’ performance in close to clinical conditions (‘operating region’) was analysed in this report. The ‘operating region’ in the case of the BP80 is positioned around the pressure-flow curve at a pump speed of 3000 rpm. In the case of the Rotaflow, the ‘operating region’ was between the pump pressure-flow curves at a speed of 3000 and 4000 rpm, and the DP2 was found between 7000 and 8000 rpm. The standard deviation of mean pressure through the pump was used to characterise the stability of the pump. In experiments with outlet stagnation, the BP80 demonstrated high negative association between flow and pressure variability (r=-0.68, p <0.001). In experiments with the DP2, this association was positive (r=-0.68, pB <0.001). All pumps demonstrated significantly higher variability of pressure in experiments with inlet stagnation in comparison to the experiments with outlet stagnation. The rise of relative temperature in the inlet of a pump was closely related to the flow rate. The heating of fluid was more pronounced in the ‘zero-flow’ mode, especially in experiments with inlet stagnation. In summary, (1) the ‘zero-flow’ regime, which is described in the manuals of some commercially-available pumps, is the use of the pump outside the allowable operating region. It is potentially dangerous and should, therefore, never be used in clinical settings. (2) Using centrifugal pumps for kinetic-assisted venous return can only be performed safely when the negative pressure at the inlet of the pump is monitored continuously. The maximum allowable negative pressure has to be defined for each type of pump, and must be based on pump performance.
Kinematics and Electromyography of Landing Preparation in Vertical Stop-Jump
Authors: Chappell Jonathan D. , Creighton R. Alexander , Giuliani Carol , Yu Bing , Garrett William E. 
Published: January 2007

Background Biomechanical analysis of stop-jump tasks has demonstrated gender differences during landing and a potential increase in risk of noncontact anterior cruciate ligament injury for female athletes. Analysis of landing preparation could advance our understanding of neuromuscular control in movement patterns and be applied to the development of prevention strategies for noncontact anterior cruciate ligament injury. Hypothesis There are differences in the lower extremity joint angles and electromyography of male and female recreational athletes during the landing preparation of a stop-jump task. Study Design Controlled laboratory study. Methods Three-dimensional videographic and electromyographic data were collected for 36 recreational athletes (17 men and 19 women) performing vertical stop-jump tasks. Knee and hip angular motion patterns were determined during the flight phase before landing. Results Knee and hip motion patterns and quadriceps and hamstring activation patterns exhibited significant gender differences. Female subjects generally exhibited decreased knee flexion (P = .001), hip flexion (P = .001), hip abduction (P = .001), and hip external rotation (P = .03); increased knee internal rotation (P = .001); and increased quadriceps activation (P = .001) compared with male subjects. Female subjects also exhibited increased hamstring activation before landing but a trend of decreased hamstring activation after landing compared with male subjects (P = .001). Conclusion Lower extremity motion patterns during landing of the stop-jump task are preprogrammed before landing. Female subjects prepared for landing with decreased hip and knee flexion at landing, increased quadriceps activation, and decreased hamstring activation, which may result in increased anterior cruciate ligament loading during the landing of the stop-jump task and the risk for noncontact ACL injury.
The Effect of Anterior Cruciate Ligament Deficiency on the in Vivo Elongation of the Medial and Lateral Collateral Ligaments
Authors: Van de Velde Samuel K. , Defrate Louis E. , Gill Thomas J. , Moses Jeremy M. , Papannagari Ramprasad , Li Guoan 
Published: January 2007

Background Although anterior cruciate ligament deficiency has been shown to lead to joint degeneration, few quantitative data have been reported on its effect on soft tissue structures surrounding the knee joint. Hypothesis Anterior cruciate ligament deficiency will alter the deformation of both collateral ligaments during in vivo weight-bearing knee function from 0° to 90°. Study Design Controlled laboratory study. Methods Six patients who had acute anterior cruciate ligament injury in 1 knee with the contralateral side intact participated in this study. Using magnetic resonance and dual orthogonal fluoroscopic imaging techniques, we measured the length of the fiber bundles of the superficial medial collateral ligament, deep medial collateral ligament, and lateral collateral ligament of the 6 patients; the healthy contralateral knee of each patient served as a control. Results Anterior cruciate ligament injury caused a significant elongation of the fiber bundles of the superficial and deep medial collateral ligament at every flexion angle. In contrast, the lateral collateral ligament fiber bundles shortened after anterior cruciate ligament injury. Conclusion The altered deformations of the collateral ligaments associated with the changes in tibiofemoral joint kinematics after anterior cruciate ligament injury demonstrate that deficiency of 1 of the knee joint structures upsets the in vivo knee homeostasis. Clinical Relevance Restoring normal knee kinematics after anterior cruciate ligament reconstruction is critical to restore the normal function of the collateral ligaments.
Passive Stability Characteristics of Ankle Braces and Tape in Simulated Barefoot and Shod Conditions
Authors: Eils Eric , Imberge Simone , Völker Klaus , Rosenbaum Dieter 
Published: January 2007

Background Ankle sprains are among the most common injuries in barefoot sport activities such as dance, gymnastics, or trampoline. At present, the use of external ankle devices for prevention of ligament injuries for barefoot activities remains unclear. Hypothesis External ankle devices have a significant loss of passive stability when used without a shoe in barefoot activities. Study Design Controlled laboratory study. Methods Twenty-five healthy subjects participated in the project (mean age, 26.2 ± 3.3 years; mean body mass, 71.2 ± 10.3 kg; mean height, 178 ± 7 cm). Passive range of motion measurements were performed with 3 different ankle stabilizers (a stirrup brace, a lace-up brace, and tape), as well as 2 different shoe conditions (cutout shoe [simulated barefoot] and normal shoe). Results In the simulated barefoot condition, a significantly reduced stabilizing effect for inversion and eversion (19% and 29%, respectively) was found for the stirrup ankle brace. Small decreases were noted with the soft brace and tape, but these were not statistically significant. Conclusion The passive stability characteristics of ankle braces depend to a great extent on being used in combination with a shoe. This is especially true for semirigid braces with stirrup design. Therefore, it is recommended that soft braces (like the one tested in the present investigation) be used in barefoot sports for restricting passive range of motion of the foot and ankle complex. Clinical Relevance This study provides useful information for clinicians to select or recommend an external ankle stabilizing device in barefoot sports to restrict passive range of motion of the foot-ankle complex most effectively.
The oxidative stress response regulates DKK1 expression through the JNK signaling cascade in multiple myeloma plasma cells
Authors: Colla Simona , Zhan Fenghuang , Xiong Wei , Wu Xiaosong , Xu Hongwei , Stephens Owen , Yaccoby Shmuel , Epstein Joshua , Barlogie Bart , Shaughnessy John D. 
Published: January 2007

Abstract
Multiple myeloma (MM) plasma cells, but not those from healthy donors and patients with monoclonal gammopathy of undetermined significance or other plasma cell dyscrasias involving the bone marrow, express the Wnt-signaling antagonist DKK1. We previously reported that secretion of DKK1 by MM cells likely contributes to osteolytic lesions in this disease by inhibiting Wnt signaling, which is essential for osteoblast differentiation and survival. The mechanisms responsible for activation and regulation of DKK1 expression in MM are not known. Herein, we could trace DKK1 expression changes in MM cells to perturbations in the JNK signaling cascade, which is differentially modulated through oxidative stress and interactions between MM cells with osteoclasts in vitro. Despite its role as a tumor suppressor and mediator of apoptosis in other cell types including osteoblasts, our data suggest that DKK1, a stress-responsive gene in MM, does not mediate apoptotic signaling, is not activated by TP53, and its forced overexpression could not inhibit cell growth or sensitize MM cells to apoptosis following treatment with thalidomide or lenalidomide. We conclude that specific strategies to modulate persistent activation of the JNK pathway may be beneficial in preventing disease progression and treating myeloma-associated bone disease by inhibiting DKK1 expression.
Talc mediates angiostasis in malignant pleural effusionsviaendostatin induction
Authors: Najmunnisa N. , Mohammed K. A. , Brown S. , Su Y. , Sriram P. S. , Moudgil B. , Loddenkemper R. , Antony V. B. 
Published: January 2007

Talc remains the most effective sclerosing agent for pleurodesis. However, its mechanism of action in resolving pleural malignant disease remains unclear.The present study evaluated the angiogenic balance in the pleural space in patients with malignant pleural effusions (MPE) following talc insufflation.Patient pleural fluid samples were collected both before and after talc insufflation. The ability of pleural mesothelial cells (PMC) and malignant mesothelioma cells (MMC) to produce endostatinin vitrowas compared. The biological effects of pleural fluids and conditioned media from talc-activated PMC on endothelial cells were evaluated by performing proliferation, invasion, tube formation and apoptosis assays.Pleural fluids from patients with MPE who received thoracoscopic talc insufflation contained significantly higher levels of endostatin (median 16.75 ng·mL−1) compared with pre-talc instillation (1.06 ng·mL−1). Talc-activated PMC released significantly greater amounts of endostatin (mean±sem1052.39±38.66 pg·mL−1) when compared with a MMC line (134.73±8.72 pg·mL−1).In conlusion, talc alters the angiogenic balance in the pleural space from a biologically active and angiogenic environment to an angiostatic milieu. Functional improvement following talc poudrage in patients with malignant pleural effusions may, in part, reflect these alterations in the pleural space.
Increased galectin-3 expression and intra-epithelial neutrophils in small airways in severe COPD
Authors: Pilette C. , Colinet B. , Kiss R. , André S. , Kaltner H. , Gabius H-J. , Delos M. , Vaerman J-P. , Decramer M. , Sibille Y. 
Published: January 2007

Galectins-1 and -3 regulate epithelial proliferation/apoptosis and neutrophil activation, and are implicated in lung cancer and asthma. The role of galectins in chronic obstructive pulmonary disease (COPD), characterised by epithelial changes and neutrophil infiltration, remains unknown.In the present study, galectin-1 and -3 expression was assessed by immunohistology in the bronchial epithelium of lung specimens from eight severe COPD patients and compared with nine nonsmokers and six smokers without COPD. Findings were related to epithelial proliferation (Ki-67), tissue inflammation and lung function.Epithelial galectin-3 immunostaining was increased only in the small airways of COPD patients when compared with nonsmokers and smokers. In contrast, galectin-1 was only significantly increased in the small airways of the group of smokers. Ki-67+ epithelial cells and neutrophils were increased in the small airways of COPD patients when compared with smokers. Furthermore, intra-epithelial neutrophils correlated in the small airways with Ki-67+ epithelial cells and with the forced expiratory volume in one second/forced vital capacity ratio. However, no correlation was observed with galectin expression.The present study supports the hypothesis that distal airways represent an important site for detecting changes in chronic obstructive pulmonary disease. In patients with severe disease, an increased galectin-3 expression and neutrophil accumulation in the small airway epithelium was demonstrated, correlating with epithelial proliferation and airway obstruction.
The role of nebulised budesonide in the treatment of exacerbations of COPD
Authors: Gunen H. , Hacievliyagil S. S. , Yetkin O. , Gulbas G. , Mutlu L. C. , In E. 
Published: January 2007

The present study was designed to evaluate the hypothesis that nebulised budesonide (NB) might be an alternative to systemic corticosteroids (SC) in the treatment of patients with exacerbations of chronic obstructive pulmonary disease (ECOPD).Patients hospitalised with ECOPD (n = 159) were randomised into three groups. Group 1 received only standard bronchodilator treatment (SBDT), group 2 received SC (40 mg prednisolone) plus SBDT, and group 3 received NB (1,500 μgq.i.d.) plus SBDT. Improvement during 10-day hospitalisation was compared with exacerbation and rehospitalisation rates after discharge.While mean±sdage was 64.1±8.9 yrs (female/male = 0.1), mean forced expiratory volume in one second (FEV1) at admission was found to be 37.2±12.2% predicted. Arterial blood gases and spirograms recovered faster in groups 2 and 3. While improvements in arterial oxygen tension (Pa,O2) and forced vital capacity (FVC) in group 2, and improvements inPa,O2, FVC and FEV1in group 3, became significant at 24-h control, the first significant improvement in group 1 appeared in arterial oxygen saturation at 72-h control. The mean improvement ofPa,O2after 10 days was 1.20 and 1.06 kPa (9 and 8 mmHg) higher in group 2 and 3, respectively, than in group 1. Blood glucose exhibited an upward trend only in group 2.The study demonstrates that nebulised budesonide may be an effective and safe alternative to systemic corticosteroids in the treatment of exacerbations of chronic obstructive pulmonary disease.
Childhood adiposity predicts adult-onset current asthma in females: a 25-yr prospective study
Authors: Burgess J. A. , Walters E. H. , Byrnes G. B. , Giles G. G. , Jenkins M. A. , Abramson M. J. , Hopper J. L. , Dharmage S. C. 
Published: January 2007

Few data exist on associations between childhood adiposity and incident asthma in later life. The present authors examined the relationship between childhood body mass index (BMI) and incident asthma beginning in adolescence or in adult life.All subjects included in the study were participants in the Tasmanian Asthma Survey, a large population-based cohort study, and were asthma free at 7 yrs of age. Weight, height and lung function were measured at 7 yrs of age. Asthma status at 7 and 32 yrs of age was ascertained by questionnaire. Odds ratios were calculated for the association between childhood adiposity, expressed as “overweight” or as BMI z-score quartiles at 7 yrs of age, and asthma development after that age.In females, but not in males, there was a significant association between adiposity at 7 yrs of age and current asthma at 32 yrs of age that developed after the age of 21 yrs. The association was not explained by childhood lung function or age at menarche. There was no association between adiposity at 7 yrs of age and asthma that developed after that age and remitted at 32 yrs of age in either sex.Higher body mass index in nonasthmatic young females at 7 yrs of age predicts risk of current asthma developing in adult life.
Air pollution and development of asthma, allergy and infections in a birth cohort
Authors: Brauer M. , Hoek G. , Smit H. A. , de Jongste J. C. , Gerritsen J. , Postma D. S. , Kerkhof M. , Brunekreef B. 
Published: January 2007

Few studies have addressed associations between traffic-related air pollution and respiratory disease in young children. The present authors assessed the development of asthmatic/allergic symptoms and respiratory infections during the first 4 yrs of life in a birth cohort study (n = ∼4,000).Outdoor concentrations of traffic-related air pollutants (nitrogen dioxide PM2.5, particles with a 50% cut-off aerodynamic diameter of 2.5 μm and soot) were assigned to birthplace home addresses with a land-use regression model. They were linked by logistic regression to questionnaire data on doctor-diagnosed asthma, bronchitis, influenza and eczema and to self-reported wheeze, dry night-time cough, ear/nose/throat infections and skin rash. Total and specific immunoglobulin (Ig)E to common allergens were measured in a subgroup (n = 713).Adjusted odds ratios (95% confidence intervals) per interquartile pollution range were elevated for wheeze (1.2 (1.0–1.4) for soot), doctor-diagnosed asthma (1.3 (1.0–1.7)), ear/nose/throat infections (1.2 (1.0–1.3)) and flu/serious colds (1.2 (1.0–1.4)). No consistent associations were observed for other end-points. Positive associations between air pollution and specific sensitisation to common food allergens (1.6 (1.2–2.2) for soot), but not total IgE, were found in the subgroup with IgE measurements.Traffic-related pollution was associated with respiratory infections and some measures of asthma and allergy during the first 4 yrs of life.