Prospective, randomized trial comparing blood and oxygenated crystalloid cardioplegia in reoperative coronary artery bypass grafting

OBJECTIVES: Reoperative coronary artery bypass grafting presents unique challenges for myocardial preservation. The purpose of this study was to compare oxygenated blood cardioplegia with oxygenated crystalloid cardioplegia during reoperative coronary artery bypass grafting using transesophageal echocardiography to assess regional wall motion of the left ventricle before and after cardiopulmonary bypass. METHODS: Sixty-one patients undergoing reoperative coronary artery bypass grafting were prospectively randomized to receive oxygenated blood cardioplegia or oxygenated crystalloid cardioplegia delivered with a combined antegrade-retrograde technique. Transgastric short axis views of the left ventricle were made with transesophageal echocardiography during the operation before cardiopulmonary bypass and immediately after cardiopulmonary bypass. Regional wall motion was graded by a blinded observer, and before cardiopulmonary bypass scores were compared with after cardiopulmonary bypass scores. RESULTS: No significant differences were found in the change in regional wall motion score from before cardiopulmonary bypass to after cardiopulmonary bypass between the blood and crystalloid cardioplegia groups. CONCLUSIONS: This study found blood and crystalloid cardioplegia to be equally efficacious for myocardial preservation during reoperative coronary artery bypass grafting.     

Laparoscopic cholecystectomy in pancreas transplant recipients

Laparoscopic cholecystectomy is the treatment of choice for symptomatic cholelithiasis. Since its introduction in 1987, this procedure has been employed with increasing frequency as its safety has been documented in numerous studies. Absolute contraindications to laparoscopic cholecystectomy have become relative contraindications, and patients previously felt to be at excessive risk for laparoscopic cholecystectomy are viewed as patients who may benefit from laparoscopic cholecystectomy. The use of this procedure in patients with comorbid medical conditions has the potential to decrease patient morbidity. Patients who have previously undergone solid organ transplantation and require immunosuppressive therapy are a group of patients who may benefit from laparoscopic cholecystectomy. We report four patients who have previously undergone combined renal and pancreas transplantation who underwent successful laparoscopic cholecystectomy.     

Steps towards a consumer-driven ‘concept innovation machine’ for food and drink

Innovation is often left to insight and serendipity. A lot of what researchers call innovation is actually a process by which one can make the individual consumer or practitioner more ‘creative’. Although it is important to work with the creative individual in hopes of coming up with the better ‘idea’ and new product/service opportunity, an equally valid albeit novel and counterintuitive approach systematizes creativity in a ‘research-driven machine’. This paper presents an approach to the systematization, based upon the point of view that creativity and innovation comprise the recombination of components into new blends. Given this point of view, to then spur innovation requires a systematic database that the user can access, with tools to help manipulate that database. The paper shows how such a database can be constructed and then used to create a novel product. The approach provides a general framework for the sensory professional to become more involved in the early stages of product development, where the focus is on the conceptual aspects of food features rather than on their physical manifestations in actual products.     

了解高级处理器特点提高编码效率

如今的数字信号处理器(DSP)在性能、外围设备集成、功耗和成本方面都具备很多优势,很多系统设计人员希望在原有系统设计中利用DSP获得比传统处理器更好的效益。但其中一个     

Drafting a parenteral nutrition order form utilizing a physician assessment process

The utilization of a physician critique process in the design of a parenteral nutrition order form, encouraging a standard order option, is assessed. In the critique process, physicians from surgery, medicine, and medical intensive care teams were tasked to use the draft order form and guideline sheet to prescribe a parenteral nutrition order for a hypothetical patient. Prescriber recommendations and problems with the nutrition order form and guideline sheet directed editorial improvements. The physician assessment process is an effective means to measure utility of a draft parenteral order form and prescribing guideline sheet. By utilizing physician expertise, deficiencies inherent in such an order form may be corrected prior to implementation.     

FDTD analysis of electromagnetic wave radiation from systemscontaining horn antennas

The application of the finite-difference time-domain (FDTD) method to various radiating structures is considered. These structures include two- and three-dimensional waveguides, flared horns, a two-dimensional parabolic reflector, and a two-dimensional hyperthermia application. Numerical results for the horns, waveguides, and parabolic reflectors are compared with results from using the method of moments (MM). The results for the hyperthermia application are shown as extensions of the previously validated models. This new application of the FDTD method is shown to be useful when other numerical or analytic methods cannot be applied     

Elevation of serum cholesterol levels in mice by the antioxidant butylated hydroxyanisole

The food antioxidants butylated hydroxyanisole (BHA) and butylated hydroxytoluene (BHT) are structurally related to the hypocholesterolemic drug probucol. The purpose of this study was to determine if BHA can lower serum cholesterol levels as is observed with probucol. Treatment of mice with 0.75% BHA in their feed for 10 days resulted in a significant (P < or = 0.01) elevation of serum cholesterol levels. This effect contrasts with the cholesterol-lowering effect of probucol. Further, the degree of cholesterol elevation was comparable to that observed in mice administered 3% cholesterol in their feed for 7 days. The enzyme acyl CoA:cholesterol acyltransferase (ACAT) was decreased significantly (P < or = 0.01) in liver microsomes from BHA-treated mice. In contrast, hepatic microsomal ACAT activity was increased significantly (P < or = 0.01) in cholesterol-fed mice. These results suggested that the increased serum cholesterol observed in BHA-treated mice was not accompanied by an increase in hepatic cholesterol levels. Indeed, hepatic microsomal cholesterol levels were reduced in BHA-treated mice, but were increased significantly (P < or = 0.01) in cholesterol-fed mice. These results demonstrate that the common food additive BHA elevates serum cholesterol levels by a mechanism that apparently involves the decreased uptake of cholesterol by the liver.