bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of RGD‐Immobilized Dual‐Pore Poly(l‐Lactic Acid) Scaffolds on Chondrocyte Proliferation and Extracellular Matrix Production
Authors: Jung Hyun Jung , Park Kwideok , Kim Jae‐Jin , Lee Jin Ho , Han Ki‐Ok , Han Dong Keun 
Published: December 2008

AbstractInteractions between cell and polymer surface have great implications in tissue engineering. In this study, chondrocyte proliferation and matrix production were examined using porous poly(l‐lactide) (PLLA) scaffolds that have different surface characteristics. PLLA scaffolds were prepared using a gas‐foaming method, and subjected to surface modifications through plasma treatment and subsequent in situ grafting of hydrophilic acrylic acid (AA). To immobilize peptide ligands, the AA‐grafted PLLA scaffolds (PLLA‐PAA) were further reacted with either Gly‐Arg‐Asp‐Gly (GRDG) or Gly‐Arg‐Gly‐Asp (GRGD) to produce PLLA‐PAA‐GRDG or PLLA‐PAA‐GRGD scaffold, respectively. The average porosities of the scaffolds were more than 90%, and their pore sizes ranged from 200∼300 to 10∼50 µm for large and small pores, respectively. The concentrations of each bound component were 2.14 × 10−4 mmol/cm2 for AA, 1.87 nmol/g for GRDG, and 1.68 nmol/g for GRGD. When chondrocytes were seeded onto the different PLLA scaffolds, cell adhesion and proliferation were highly affected as the substrate types vary. The RGD‐immobilized scaffolds resulted in higher cellularity and better accumulation of total glycosaminoglycan than the others. Histological staining of Safranin O showed that the deposited extracellular matrix was more intense and widely distributed in the PLLA‐PAA‐GRGD scaffold. The present data suggest that immobilization of RGD peptide on the AA‐grafted PLLA scaffold can be an effective tool for chondrocyte attachment and proliferation, and that it may also be helpful to facilitate cartilaginous tissue formation.
Temperature Control Using a Heat Exchanger of a Cardioplegic System in Cardiopulmonary Bypass Model for Rats
Authors: Kim Won Gon , Choi Se Hun , Kim Jin Hyun 
Published: December 2008

AbstractSmall animal cardiopulmonary bypass (CPB) model would be a valuable tool for investigating pathophysiological and therapeutic strategies on bypass. However, the rat CPB models have a number of technical limitations. Effective maintenance and control of core temperature by heat exchanger (HE) is among them. The purpose of this study was to confirm the effect of rectal temperature maintenance and hypothermic control using a HE of cardioplegia system in CPB model for rats. The miniature circuit consisted of a reservoir, HE, membrane oxygenator, and roller pump; the static priming volume was 40 cc. In the first stage of experiment, 10 male Sprague‐Dawley rats were divided into two groups; HE group was subjected to CPB with HE from a cardioplegia system, and control group was subjected to CPB with warm water circulating around the reservoir. Partial CPB was conducted at a flow rate of 40 mg/kg/min for 20 min after venous cannulation (via the internal jugular vein) and arterial cannulation (via the femoral artery). Rectal temperature was measured after anesthetic induction, after cannulation, 5, 10, 15, and 20 min after CPB. Arterial blood gas with hematocrit was also analyzed, 5 and 15 min after CPB. In the second stage with the same experimental setting, rectal temperatures were lowered in 10 rats to the target temperature of 32°C. After reaching the target temperature, animals were rewarmed. Rectal temperature was measured after cannulation, 5, 10, 15, 20, 25, and 30 min after CPB. Arterial blood gas with hematocrit was also analyzed, 5 and 15 min after CPB. Rectal temperature change differed between the two groups (P < 0.01). The temperatures of the HE group were well maintained during CPB, whereas the control group was under progressive hypothermia. Rectal temperature 20 min after CPB was 36.16 ± 0.32°C in the HE group and 34.22 ± 0.36°C in the control group. In the second set of experiments, the hypothermia targeted (32°C) was reached in 15 min (from 35.56 ± 1.05°C to 31.75 ± 0.47°C). The rats were successfully rewarmed within the observation period of 30 min. Arterial blood gases and hematocrits showed no further significant findings. We confirmed the effect of rectal temperature maintenance and hypothermic control using an HE of cardioplegia system in CPB model for rats. This model would be a valuable tool for further use in hypothermic CPB experiments in rats.
Using Detachment‐Promoting Agents for the Prevention of Chronic Peritoneal Dialysis‐Associated Infections
Authors: Branger Bernard , Marion Karine , Bergeron Emmanuelle , Perret Cécile , Zabadani Bachir , Reboul Pascal , Freney Jean 
Published: December 2008

AbstractBiofilms are known to be responsible for chronic peritoneal dialysis (PD)‐related infections. Such infections are still frequent among patients in PD. The aim of this study was to develop a new approach in the prevention of chronic PD‐related infection by regular injection of specific formulations containing detachment‐promoting agents. A biofilm reactor system reproducing PD‐like operating conditions was developed. A first set of experiments allowed the assessment of the anti‐biofilm efficacy of various formulations. Then, experiments were performed for a longer duration and selected formulations were tested and compared with taurolidine. Biofilm removal was quantified by calculating the percentage of coverage reduction compared with an untreated control. A regular weekly treatment led to a 97% reduction of the surface coverage although a daily treatment with taurolidine still left 48% of the biomass on the surface. Such treatment is recommended to reduce the frequencies of chronic PD‐related infections.
Oxygen Delivery and Hemoglobin Concentration in Cardiac Surgery: When Do We Have Enough?
Authors: Slight Robert D. , Lux Danielle , Nzewi Onyekwelu C. , McClelland David B.L. , Mankad Pankaj S. 
Published: December 2008

AbstractFor many years it has been assumed that patients undergoing cardiac surgery utilizing cardiopulmonary bypass accumulate an “oxygen debt” that requires a higher postoperative hemoglobin concentration for its reversal. Much of this evidence has now been discredited due to mathematical error with recent research suggesting critical levels of oxygen delivery are lower than previously thought. This article aims to explore the relationship between observed and critical oxygen delivery with an estimation of the minimal hemoglobin required. This was a single‐center observational study. Nineteen adult elective cardiac surgery patients were recruited to participate with four subsequently excluded. Observed measurements of oxygen delivery were recorded and compared with calculated “critical” values adjusted for temperature. The hemoglobin value that represented critical oxygen delivery was compared with the observed value to identify any “hemoglobin reserve.” At no perioperative time point did observed oxygen delivery or critical hemoglobin concentration significantly approach its corresponding critical value. Current transfusion practice in noncritically ill cardiac surgery patients may be considered excessive if systemic oxygen requirement is the sole parameter considered.
Subcutaneous Transposition of the Superficial Femoral Artery for Arterioarterial Hemodialysis: Technique and Results
Authors: Salgado Octavio J. , Terán Nemesio A. , Rosales Beatriz , Garcia Rafael A. 
Published: December 2008

AbstractWe report the use of subcutaneous transposition of the femoral artery (STFA) for placement of both inflow and outflow needles in 14 hemodialysis (HD) adult patients with difficult access. Follow‐up time was 318 months during which a total of 3215 arterioarterial HD sessions were done. Kt/V values ranged between 0.71 and 1.59. Elevated access recirculation and dialysis outflow pressures were common findings to all patients. Complications were: (i) two episodes of bleeding secondary to puncture‐related arterial wall laceration, repaired by stitching; (ii) three episodes of thrombosis in two patients, all successfully declotted; (iii) three puncture‐related complications needing placement of a vein interposition graft, namely, aneurysm, pseudoaneurysm, and arterial stenosis; and (iv) one case of arterial ligation because of suppurative puncture site infection, without subsequent distal ischemia signs or claudication. The use of STFA should only be reserved for patients in urgent need for vascular access with no remaining options.
Juvenile Myoclonic Epilepsy: More Trials Are Needed to Guide Therapy
Authors: Abou-Khalil Bassel W. 
Published: December 2008

Levetiracetam for the Treatment of Idiopathic Generalized Epilepsy with Myoclonic Seizures. Noachtar S, Andermann E, Meyvisch P, Andermann F, Gough WB, Schiemann-Delgado J, For the N166 Levetiracetam Study Group. Neurology 2008;70:607–616. Background Currently, there are no published randomized controlled trials evaluating the efficacy and safety of adjunctive antiepileptic therapy in idiopathic generalized epilepsy with myoclonic seizures. Methods This randomized, double-blind, placebo-controlled multicenter trial assessed the efficacy and tolerability of adjunctive treatment with levetiracetam 3,000 mg/day in adolescents (12 years) and adults (65 years) with idiopathic generalized epilepsy, who experienced myoclonic seizures on 8 days during a prospective 8-week baseline period, despite antiepileptic monotherapy. The 8-week baseline period was followed by 4-week up-titration, 12-week evaluation, and 6-week down-titration/conversion periods. Results Of 122 patients randomized, 120 (levetiracetam, n = 60; placebo, n = 60) were evaluable. Diagnoses were either juvenile myoclonic epilepsy (93.4%) or juvenile absence epilepsy (6.6%). A reduction of 50% in the number of days/week with myoclonic seizures was seen in 58.3% of patients in the levetiracetam group and in 23.3% of patients in the placebo group ( p < 0.001) during the treatment period. Levetiracetam-treated patients were more likely to respond to treatment than patients receiving placebo (OR = 4.77; 95% CI, 2.12 to 10.77; p < 0.001). Levetiracetam-treated patients had higher freedom from myoclonic seizures (25.0% vs 5.0%; p = 0.004) and all seizure types (21.7% vs 1.7%; p < 0.001) during the evaluation period. The only adverse events more frequent with levetiracetam were somnolence and neck pain. Conclusion These results suggest that levetiracetam is an effective and well-tolerated adjunctive treatment for patients with previously uncontrolled idiopathic generalized epilepsy with myoclonic seizures.
Patients with Seizure Clusters—Identification of a High-Risk Group
Authors: Garcia Paul 
Published: December 2008

Seizure Clustering During Drug Treatment Affects Seizure Outcome and Mortality of Childhood-Onset Epilepsy. Sillanpää M, Schmidt D. Brain 2008;131(Pt 4):938–944. To provide evidence of whether seizure clustering is associated with drug resistance and increased mortality in childhood-onset epilepsy, a prospective, long-term population-based study was performed. One hundred and twenty patients who had been followed since disease onset (average age 37.0 years, SD 7.1, median 40.0, range 11–42; incident cases) were included. At the end of the follow-up period, 26 (11 boys) of these patients (22%) had recorded clusters of seizures. Fourteen recorded pre-treatment clusters, including 10 patients with clusters as first seizures; and in 12 patients, clusters occurred during treatment. In these 12 patients, first clustering began after 16 (range 0–35; median 15) years of treatment. Compared with the patients without clusters, those with clusters more often had at least one seizure per week at the initial stage (63% versus 32%, P = 0.0178) and during the follow-up period ( P-value varied from 0.0464 to 0.0064). Patients having seizure clusters during drug therapy were more likely to have drug resistant epilepsy compared to those not experiencing seizure clusters (42% versus 13%; P = 0.0102) and had a lower rate of entering 5-year terminal remission ( P = 0.0039) and 5-year remission ( P = 0.0230). In addition, the risk of death was significantly increased among patients with seizure clusters during drug therapy compared with those who had not experienced any clustering (42% versus 14%; P = 0.0299 two-sided Fisher's exact test). The risk ratio for patients with clusters was 3.49 (95%CI1.25–9.78). In contrast, patients with seizure clustering prior to, but not during, treatment versus those with no clustering showed no difference in seizure outcome or mortality risk. In conclusion, clustering of seizures during treatment, but not prior to treatment, is associated with a poorer long-term seizure and mortality outcome.
Production Assistance for Cellular Therapies (PACT): four‐year experience from the United States National Heart, Lung, and Blood Institute (NHLBI) contract research program in cell and tissue therapies
Authors: Reed William , Noga Stephen J. , Gee Adrian P. , Rooney Cliona M. , Wagner John E. , McCullough Jeffrey , McKenna David H. , Whiteside Theresa L. , Donnenberg Albert D. , Baker Acacia K. , Lindblad Robert W. , Wagner Elizabeth L. , Mondoro Traci Heath 
Published: December 2008

BACKGROUND: In 2002, the US National Heart, Lung, and Blood Institute (NHLBI) conducted a workshop to determine needs of the cell therapy community. A consensus emerged that improved access to cGMP facilities, regulatory assistance, and training would foster the advancement of cellular therapy.STUDY DESIGN AND METHODS: A 2003 NHLBI request for proposals resulted in four contracts being awarded to three cell‐manufacturing facilities (Baylor College of Medicine, University of Minnesota, and University of Pittsburgh) and one administrative center (The EMMES Corporation). As a result, Production Assistance for Cellular Therapies (PACT) was formed.RESULTS: As of October 1, 2008, PACT has received 65 preliminary applications of which 45 have been approved for product manufacture. A variety of cell therapies are represented including T‐regulatory cells, natural killer cells, adipose‐derived stem cells, cardiac progenitor cells for cardiac disease, hematopoietic progenitor cells (HPCs) for central nervous system applications, cytotoxic T lymphocytes, and dendritic cells. A total of 169 products have been administered under 12 applications and 2 reagents were manufactured and delivered. Fourteen peer‐reviewed publications and 15 abstracts have resulted from the PACT project to date. A cell therapy textbook is nearly complete. PACT technical projects have addressed assay development, rapid endotoxin testing, shipping of cell products, and CD34+ HPC isolation from low‐volume marrow. Educational Web seminars and onsite training through workshops have been conducted.CONCLUSIONS: PACT is an active and successful cell therapy manufacturing resource in the United States, addressing research and training while forging relationships among academia, industry, and participating institutions.
The JAL antigen (RH48) is the result of a change in RHCE that encodes Arg114Trp
Authors: Westhoff Connie M. , Vege Sunitha , Wylie Dwane , Nickle Pam , Lomas‐Francis Christine , Hue‐Roye Kim , Reid Marion E. 
Published: December 2008

BACKGROUND: The JAL antigen (Rh48) was discovered more than 30 years ago when it caused hemolytic disease of the fetus and newborn in an African American family. A decade later it was found to cause hemolytic disease of the fetus and newborn in a Caucasian family. The presence of the same low‐prevalence antigen in two different ethnic groups is rare, but additional JAL+ in both groups was subsequently identified. This study was undertaken to investigate the RH gene(s) responsible for expression of JAL and to determine the structural relationship between JAL and other Rh antigens.STUDY DESIGN AND METHODS: Samples from 17 JAL+ people were included: 2 Caucasian, 6 African American, 7 African Brazilian, 1 Caribbean, and 1 Puerto Rican. RHCE and RHD were investigated at the genomic level, and Rh cDNAs were cloned and sequenced for some samples.RESULTS: Caucasian JAL+ probands had RHCE*Ce, while JAL+ probands with African ancestry had RHCE*ce, but all had a nucleotide 340C>T change in Exon 3 of RHCE predicted to encode Arg114Trp. The JAL‐encoding RHCE*ce also had 733C>G (Leu245Val) and was linked to conventional RHD or to RHD*DAU0.CONCLUSIONS: JAL+ results from a nucleotide 340C>T (Arg114Trp) on either a Ce or ce background. Homology modeling of the JAL+ RhCE protein suggests that the Arg→Trp change eliminates a critical loop‐stabilizing H‐bond between the side chain of Arg114 and the e‐specific amino acid Ala226. Additionally, accommodation of the bulky tryptophan would disrupt the conformation of the extracellular loops containing C/c‐ and e‐specific amino acids, providing a structural hypothesis for the simultaneous altered expression of C/c, e, and V/VS antigens.
The Effects of Rate‐Adaptive Atrial Pacing Versus Ventricular Backup Pacing on Exercise Capacity in Patients with Left Ventricular Dysfunction
Authors: PASSMAN ROD , BANTHIA SMRITI , GALVEZ DINITA , SHELDON TODD , KADISH ALAN 
Published: December 2008

Background: Atrial rate‐adaptive pacing may improve cardiopulmonary reserve in patients with left ventricular dysfunction.
Methods: A randomized, blinded, single‐crossover design enrolled dual‐chamber implantable defibrillator recipients without pacing indications and an ejection fraction ≤40% to undergo cardiopulmonary exercise treadmill stress testing in both atrial rate‐adaptive pacing (AAIR) and ventricular demand pacing (VVI) pacing modes. The primary endpoint was change in peak oxygen consumption (VO2). Secondary endpoints were changes in anaerobic threshold, perceived exertion, exercise duration, and peak blood pressure.
Results: Ten patients, nine males, eight with New York Heart Association class I, mean ejection fraction 24 ± 7%, were analyzed. Baseline VO2 was 3.6 ± 0.5 mL/kg/min. Heart rate at peak exercise was significantly higher during AAIR versus VVI pacing (142 ± 18 vs 130 ± 23 bpm; P = 0.05). However, there was no difference in peak VO2 (AAIR 23.7 ± 6.1 vs VVI 23.8 ± 6.3 mL/kg/min; P = 0.8), anaerobic threshold (AAIR 1.3 ± 0.3 vs VVI 1.2 ± 0.2 L/min; P = 0.11), rate of perceived exertion (AAIR 7.3 ± 1.5 vs VVI 7.8 ± 1.2; P = 0.46), exercise duration (AAIR 15 minutes, 46 seconds ± 2 minutes, 54 seconds vs VVI 16 minutes, 3 seconds ± 2 minutes, 48 seconds; P = 0.38), or peak systolic blood pressure (AAIR 155 ± 22 vs VVI 153 ± 21; P = 0.61) between the two pacing modes.
Conclusion: In this study, AAIR pacing did not improve peak VO2, anaerobic threshold, rate of perceived exertion, or exercise duration compared to VVI backup pacing in patients with left ventricular dysfunction and no pacing indications.
Atrial Fibrillation Therapy in Patients with a CRT Defibrillator with Wireless Telemetry
Authors: CROSSLEY GEORGE H. , AONUMA KAZUTAKA , HAFFAJEE CHARLES , SHODA MORIO , MEIJER ALBERT , BAUER ALEXANDER , BORIANI GIUSEPPE , SVENDSEN JESPER , THOMAS SHELLEY , WIGGENHORN CHRISTOPHER , UNTERBERG‐BUCHWALD CHRISTINA ,   for the Concerto‐AT Study Investigators
Published: December 2008

Background: Atrial fibrillation (AF) is a major cause of morbidity and mortality, especially in patients with congestive heart failure.
Objectives: The purposes of this international, prospective multicenter study were to evaluate the efficacy of atrial shock therapy in patients with a cardiac resynchronization therapy defibrillator (CRT‐D) and to evaluate the safety of the new CRT‐D. The effectiveness of a new wireless telemetry system was also evaluated.
Methods: A total of 282 patients, without permanent AF, who had indications for a CRT‐D were included. Atrial shock therapy was tested on both spontaneous and induced AF episodes. The effectiveness of the Medtronic wireless telemetry system (Conexus; Medtronic Inc., Minneapolis, MN, USA) was also tested. Secondary endpoints included the heart failure Clinical Composite Response, system performance evaluation, and adverse event summary.
Results: Atrial shock therapy was successful in 168 of 171 episodes (98.2%). Of these, 138 episodes were induced and 33 were spontaneous. Successful cardioversion occurred in 137 of the 138 induced‐AF episodes (86.1% with 12 joule (J), 13.1% with 24 J, and 0.7% with 35 J). During the first 3 months of implant, there were 43 system‐related complications in 37 subjects out of 278 subjects. There were 1,999 Conexus telemetry uses recorded during this study. This includes 282 uses during the implant procedure. There were no cases of complete loss of telemetry or any adverse events reported using this system.
Conclusion: We achieved an atrial shock efficacy of 98.2% in patients who met standard CRT‐D indications. The wireless telemetry performed well with no reported unanticipated adverse device effects.
The Effect of Dofetilide on Ventricular Defibrillation Thresholds
Authors: SIMON RON D. B. , STURDIVANT J. LACY , LEMAN ROBERT B. , WHARTON J. MARCUS , GOLD MICHAEL R. 
Published: December 2008

Introduction: High defibrillation threshold (DFT) with an inadequate defibrillation safety margin remains an infrequent but troubling problem associated with defibrillator implantation. Dofetilide is a selective class III antiarrhythmic drug that reduces DFTs in a canine model. We hypothesized that dofetilide would reduce DFTs in humans, obviating the need for complex lead systems.
Methods and Results: Sixteen consecutive patients with DFTs ≥20 J delivered energy at implant‐received dofetilide therapy and underwent follow‐up DFT testing acutely following drug loading and/or chronically (128 ± 94 days). Amiodarone was discontinued in four patients at implantation. With dofetilide, DFTs decreased from 28 ± 4 J to 19 ± 7 J (P < 0.0001), resulting in a safety margin of 15 ± 8 J for the implanted devices. Five patients subsequently had spontaneous arrhythmias terminated successfully with shocks.
Conclusion: Dofetilide reduces DFTs sufficiently to prevent the need for more complex lead systems. This strategy should be considered when an inadequate defibrillation safety margin is present.
Spinal Cord Stimulation and 30‐Minute Heart Rate Variability in Refractory Angina Patients
Authors: ANSELMINO MATTEO , RAVERA LAURA , DE LUCA ANNA , CAPRIOLO MICHELE , BORDESE ROBERTO , TREVI GIAN P. , GRIMALDI ROBERTO 
Published: December 2008

Background: Spinal cord stimulation (SCS) has proven antianginal and antiischemic effects in severe coronary artery disease patients, minimizing frequency, intensity, and duration of pain. The mechanism explaining these effects has been detected in a sympathicolytic effect of the SCS. We monitored 30‐minute‐long recordings of the heart rate variability (HRV) and its spectral power parameters to evaluate the influence of SCS on the sympathetic/parasympathetic balance.
Methods and Results: Eight patients underwent HRV recordings in controlled environmental conditions. The patients were seated in a relaxed position and isolated from external contacts. During three consecutive 30‐minute periods, the SCS was programmed, in a randomized fashion, to stimulate at a level generating paresthesias (ON), at a subliminal level (SUB, amplitude 80% of ON), or switched off (OFF). The low‐frequency/high‐frequency ratio during stimulation (ON) was significantly lower compared to that found while the SCS was turned OFF (0.54, 0.35–1.04 vs 1.21, 0.80–2.48; P = 0.036). The stimulation resulted in a median 52% (33–65%) reduction of the sympathetic activity compared to basal (ON vs OFF, P = 0.049).
Conclusion: No difference emerged instead comparing OFF versus SUB (P = 0.575). The stimulation effect was not influenced by the randomized sequence. Thirty‐minute SCS significantly influenced the sympathetic/parasympathetic balance reducing sympathetic modulation.