Changes in oxygen saturation and transcutaneous carbon dioxide and oxygen levels in patients undergoing fibreoptic bronchoscopy

Though women have a lower absolute risk of disease than men at all ages, almost all the risk factors for cardiovascular disease carry the same or higher relative risk for women as for men. Moreover, the attributable risk is higher in older women than in men. Epidemiologic studies show that recent decreases in coronary heart disease mortality are in some cases greater among women than men. Interventional studies show that women appear to have as good or better a response than men to cholesterol-lowering in secondary prevention. Antihypertensive drug therapy is effective in preventing clinical endpoints in elderly women. These observations imply that an overall estimation of cardiovascular risk in women needs careful consideration. Because established therapies appear to be effective in high risk women, postmenopausal and probably also elderly women are important target groups for preventive efforts. The value of prevention for premenopausal women should not be underestimated, but should on the whole be approached through population-based strategies.     

Changes in lung and chest wall properties with abdominal insufflation of carbon dioxide are immediately reversible

There is increasing interest in blood cell transplants (BCT) from normal donors as an alternative to BMT. Ten patients with relapsed or persistent leukemia after BMT received intensive cytotoxic conditioning followed by allogeneic BCT. Three BCT were from single-antigen mismatched donors; two of the corresponding recipients had rejected a BMT from the same donor. Two patients received BCT from a different donor (one matched, one single-antigen mismatched). The other six BCT were from the same, fully matched, bone marrow donors. Donors were given G-CSF to mobilize progenitor cells which were collected by a single 2-4 h leukapheresis. Methotrexate, CsA and folinic acid were used for GVHD prophylaxis for all transplants but CsA was discontinued sooner after BCT than after BMT. One patient died without engraftment having rejected a BMT from the same single-antigen mismatched donor 4 years previously. Nine patients had granulocyte recovery at a median of 14 days, up to 6 days faster than with their previous BMT. Platelet recovery was also 2-6 days faster than with BMT in four previously engrafting patients. Four patients died without platelet recovery after BCT within a year of BMT, three of treatment-related toxicity and one of relapse. Two patients developed grade II acute GVHD. Of six patients given BCT more than a year from BMT, four, all with acute leukemia, survive 7, 14, 29 and 29 months after BCT and one relapsed at 7 months. All four survivors developed chronic GVHD. These results indicate that BCT may be useful therapy for relapse occurring more than a year after BMT.     

Transcutaneous measurement of partial pressure of oxygen and carbon dioxide

Transcutaneous monitoring is noninvasive and relatively simple to use. In neonates and small infants, this monitoring technique may provide very useful clinical information. Transcutaneous gas monitoring, using conventional electrochemical techniques, provides a means of trending the values of PaO2 and PaCO2 in most patients with relatively normal cardiovascular function. In patients with compromised cardiopulmonary function and in many adults, because of different skin structure, transcutaneous gas monitoring will not accurately reflect arterial blood gas tensions. Because transcutaneous gases depend on skin perfusion, however, it may be useful in monitoring tissue perfusion, especially in patients with peripheral vascular disease and tissue flaps. The heating of the monitoring probe necessitates frequent site changes to avoid thermal injury, which make it more labor intensive than other noninvasive monitoring methods.     

Effects of oxygen and carbon dioxide on mean cell volume

PURPOSE: Renal sonography is an accepted primary imaging modality for evaluating the pediatric urinary tract. We report a new sonographic finding associated with vesicoureteral reflux (VUR). METHODS: Ten patients underwent sonographic evaluation of the kidneys and were noted to have intermittent renal collecting system dilatation that expanded and contracted during real-time scanning. These patients were further evaluated with voiding cystourethrography. RESULTS: All 10 patients were proven to have VUR on the side of the sonographic abnormality. Four patients had bilateral VUR for a total of 14 refluxing renal units. Of these 14 renal units, 1 was sonographically normal. Five of the 14 renal units had grade V VUR that required surgical reimplantation of the ureter. CONCLUSIONS: This new finding of intermittent renal collecting system dilatation may become an important predictor of VUR. The finding warrants further evaluation even when detected in patients not suspected of having VUR who are undergoing renal sonography for other reasons.     

Local regulation of collateral ventilation by oxygen and carbon dioxide

The effects of changes in CO2 and O2 on the mechanics of collateral ventilation were studied in anesthetized paralyzed dogs. A doublelumen catheter was wedged into a peripheral airway obstructing a segment of lung distal to the catheter. Through one lumen of the catheter, air, 5% CO2 in air, 10% CO2 in air, 5% O2 in N2, or 5% CO2 in N2 was infused at a constant flow (V). Pressure (Ps) was monitored through the other lumen. At functional residual capacity the resistance to collateral flor Rcoll = Ps/V. When V was interrrupted , the time for Ps to fall 63% was defined as the time constant for collateral ventilation, Tcoll. The effective compliance (Cs') = Tcoll/Rcoll. When air was replaced by 5% CO2, Rcoll fell 46.3% (+/- SE 2.8) and Tcoll fell 41.5% (+/- SE 3.0). When the CO2 concentration was increased from 5% to 10%, Rcoll fell an additional 9.2% (+/- SE 2.2) and Tcoll fell an additional 5.1% (+/- SE 4.4). When air was replaced by 5% O2 in N2, Rcoll rose 36.6% (+/- SE 6.0) and Tcoll rose 13.6% (+/- SE 10.5). No significant changes in Cs' were noted. We conclude that varying concentrations of CO2 and O2 provide potent mechanisms for the control of collateral ventillation which may be of importance in the regulation of ventillation perfusion relationships at the local level.     

Transcutaneous oxygen and carbon dioxide during treatment of critical limb ischemia with iloprost, a prostacyclin derivative

The effect of intravenous iloprost treatment (median rate: 1.6; range 1-2 ng/kg/min; 6 h daily over 4 weeks) on transcutaneous pO2 and pCO2 was studied in 8 patients with bilateral peripheral obstructive arterial disease and monolateral critical limb ischemia. Tensiometric determinations were obtained at both metatarsi in the supine and dependent position. In critically ischemic limbs, supine transcutaneous p)2 changed erratically during iloprost treatment, increasing in only three out of eight lower limbs. At variance with its inconsistent behavior in the supine position, dependent pO2 increased during drug administration (p<0.02). Transcutaneous pCO2 was unchanged by iloprost. In the contralateral, non-symptomatic limb, both supine and dependent pO2 values were increased by the drug, suggesting that systemic hemodynamic changes may participate in its effect on transcutaneous gas tension, even at infusion rates clinically titrated to avoid evident changes in blood pressure and heart rate.     

The modified bitegard: a method for administering supplemental oxygen and measuring carbon dioxide

HUGE is a database for human large proteins newly identified by Kazusa cDNA project, which aims to predict protein primary structures from sequences of human large cDNAs (>4 kb). In particular, cDNA clones capable of coding for large proteins (>50 kDa) are current targets of the project. More than 700 sequences of human cDNAs (average size, 5.1 kb) have been determined to date and deposited in the public databases. Notable information implied from the cDNAs and the predicted protein sequences can be obtained through HUGE via the World Wide Web at URL http://www.kazusa.or.jp/huge     

Usefulness of central venous oxygen saturation monitoring during cardiopulmonary resuscitation. A comparative case study with end-tidal carbon dioxide monitoring

The usefulness of continuous monitoring of central venous oxygen saturation (ScvO2) in comparison with the capnogram during cardiopulmonary resuscitation (CPR) was demonstrated in a cardiac arrest patient. ScvO2 and end-tidal carbon dioxide (ETCO2) decreased following cessation of chest compression or increased during recovery of systemic circulation. During the complete stasis of systemic circulation, when defibrillation was done, ScvO2 did not change, while ETCO2 gradually decreased. However the larger decrease in ScvO2 temporally occurred when chest compression was resumed. And also the ScvO2 monitoring had great advantage to detecting peripheral tissue oxygenation. ScvO2 seems to be no less accurate and reliable monitoring than the capnogram during CPR procedures. Since the capnogram is non-invasively and easily used in cardiac arrest patients, ScvO2 monitoring combined with the capnogram is a more preferable method for assessing the efficacy of ongoing CPR.     

Renal function and oxygen consumption during bacteraemia and endotoxaemia in rats

BACKGROUND: The hypothesis that renal failure during septic shock may occur as a result of hypoxia-related cell dysfunction was investigated in two rat models of distributive shock. METHODS: Pentobarbitone-anaesthetized rats received either a bolus (1 ml) of living Escherichia coli bacteria (hospital-acquired strain, 1 x 10(9) CFU/ml; BA-group, n = 7), or a 1-h infusion of endotoxin (E. coli O127.B8: 8 mg/kg; ET-group, n = 7), or saline to serve as time matched controls (C-group, n = 7). RESULTS: Urine flow in the BA- and ET-group reached a nadir at 1 h, but thereafter increased and reached values higher than control at 3 h. At this time point, renal oxygen delivery had decreased, in the BA-group mainly due to a fall in arterial oxygen content and in the ET-group to a fall in renal plasma flow (clearance of 131I-hippurate). However, renal oxygen extraction had significantly increased, by 31% in the BA and by 59% in the ET group, while renal oxygen consumption remained the same. Net tubular sodium reabsorption had decreased by 55% in the BA and by 25% in the ET group, due to a fall in glomerular filtration rate (clearance of creatinine). Hence, an excess oxygen consumption was found which was caused neither by an increased renal glucose release nor by the presence of an increased number of leukocytes stuck in the glomeruli. Renal tubular cells showed normal morphology. An indication that proximal tubular function in the BA and ET group remained largely intact were normal ATP levels, absence of urinary glucose, and a normal fractional excretion of sodium. However, since urine flow had increased in shocked rats at 3 h, water appeared selectively lost. CONCLUSIONS: Our data indicate that in rat models of septic shock renal failure is not caused by cortical hypoxia or a shortage of cellular energy supply.     

The influence of carbon dioxide and body position on near-infrared spectroscopic assessment of cerebral hemoglobin oxygen saturation

Near-infrared spectroscopy may allow continuous and noninvasive monitoring of regional brain hemoglobin oxygen saturation by measuring the differential absorption of infrared light by oxyhemoglobin and deoxyhemoglobin. We have previously examined the correlation between the spectroscopic signal generated by a prototype cerebral oximeter (Invos 3100; Somanetics, Troy, MI), and global brain hemoglobin oxygen saturation calculated from arterial and jugular venous bulb oxygen saturations. Because the technology does not distinguish between arterial and venous hemoglobin saturation, changes in the proportion of cerebral arterial and venous blood volume, which may result from changes in blood flow or venous distending pressure, may confound measurements. In eight conscious volunteers breathing hypoxic oxygen mixtures, we examined the influence of supine, 20 degrees Trendelenburg, and 20 degrees reverse Trendelenburg positions on the correlation of the spectroscopic measurement of cerebral oxygen saturation in the field assessed by the probe (CSfO2) and the calculated brain hemoglobin oxygen saturation (CScombO2), estimated as 0.25 x arterial saturation plus 0.75 x jugular venous bulb oxygen saturation. We found that changes in position did not influence the association between CSfO2 and CScombO2 (r2 = 0.69-0.885) during hypoxic challenge. In a second set of eight volunteers, we studied the influence of hypercapnia and hypocapnia and body position on the association between CSfO2 and CScombO2, and found that they were less well correlated (r2 = 0.366-0.976) in individual patients. Because changes in body position and Paco2 confound the relationship between CSfO2 and CScombO2, changes in CSfO2 can best be assessed if position and Paco2 are constant.     

Oxidation of aluminum-magnesium melts in air,oxygen, flue gas,and carbon dioxide

Oxidation rates of aluminum—1 to 14 pct magnesium melts in air, oxygen, flue gas, and carbon dioxide at temperatures from 600 to 1100°C were measured with an automatic recording balance. For most conditions, a protective amorphous film on the melt surface kept the oxidation rate low initially. After an interval that was shortened by increasing temperature or magnesium content, the film crystallized to magnesium oxide and magnesium aluminate, accompanied by a sudden increase in oxidation rate. Known as breakaway oxidation, this phenomenon could be produced by adding crystalline magnesium oxide or magnesium aluminate seed to melts protected with amorphous oxide. Flue gas or carbon dioxide in the atmosphere, sodium or beryllium in the alloy, or boron dusted on the surface delayed crystallization unless seed was added. Beryllium was the most effective. Flue gas from burning natural gas delayed breakaway oxidation of unseeded melts containing up to about 4 pct magnesium at normal melting furnace temperatures near 750°C. Slow melting of solid aluminum-magnesium alloy concentrated magnesium in the first liquid to melt, sharply decreasing the interval before breakaway oxidation after melting. Rapidly melting the solid increased the protective interval. Homogenizing the solid just below the melting range before rapid melting further extended the interval before the onset of breakaway oxidation.     

Cyclophosphamide-induced generation of reactive oxygen species. Comparison with morphological changes in type II alveolar epithelial cells and lung capillaries

Immunosenescence involves modifications of humoral and cellular immunity. Here we report the analysis of human leukocyte antigen (HLA) expression on T lymphocytes, B lymphocytes and monocytes of 58 healthy subjects aged 23-95 years old. Using a double staining immunofluorescence and flow cytometry analysis, we have determined the percentages of cells expressing HLA class-I and HLA-DR antigens. The number of antigenic sites expressed per cell were evaluated for HLA-ABCw, HLA-A, HLA-B, HLA-DR locus with a flow cytometry quantification technique. With advancing age, we observed: (i) a significant decrease of the percentage of T cells and B cells expressing HLA-A products; (ii) a decrease of the number of HLA class-I antigenic sites expressed per cell on the three populations tested, predominantly on B cells and in a locus-dependent fashion; (iii) a decrease of the number of HLA-DR molecules expressed per T cell, although the percentage of T cells expressing DR products was increased; (iv) a significant diminution of the percentage of B cells expressing HLA-DR molecules, without changes of the number of HLA-DR antigenic sites per cells. These changes in HLA expression with increasing age could contribute to the decreased level of immunologic responsiveness observed with ageing and contribute to the modification of antigen recognition.     

Prostaglandin E2 increases the calcium concentration in rat brown adipocytes and their consumption of oxygen

Effects of prostaglandin E2 (PGE2) were examined on the oxygen consumption and intracellular calcium concentration of rat brown adipose tissue (BAT). PGE2 0.1 nM-1 microM increased oxygen consumption of the tissue blocks of BAT, with a maximum 2-13 min after PGE2 administration. PGE2 was most effective at 1 and 10 nM, and the oxygen consumption was elevated for over 40 min. Pretreatment of BAT with indomethacin, a prostaglandin synthesis inhibitor, did not affect the increase in oxygen consumption induced by noradrenaline. PGE2 at 1-10 nM gradually increased the intracellular calcium concentration of freshly dispersed single brown adipocytes by 3-4 times in 30 min. PGF2 also increased the intracellular calcium concentration of brown adipocytes in calcium-free medium. These results raise the possibility that PGE2 and noradrenaline affect heat genesis and metabolism of BAT independently.     

The effects of hemodilution on cerebral hemodynamics and oxygen consumption during nonpulsatile hypothermic cardiopulmonary bypass

The effects of hemodilution on cerebral hemodynamics and oxygen consumption during nonpulsatile hypothermic cardiopulmonary bypass (CPB) were investigated in 16 patients undergoing elective open heart surgery under CPB. They were divided into 2 groups; high (25%) (H) and low hematocrit (15%) (L) groups according to the hematocrit values during CPB. Simultaneous measurements of blood flow velocity in the middle cerebral artery (VMCA) and oxygen tension in the jugular venous bulb (PjvbO2) were performed at prebypass, bypass, and post bypass periods. There were no significant differences in nasopharyngeal temperature (NPT), cerebral perfusion pressure, pump flow rate, and PaCO2 between the two groups at any period. VMCA changed in correlation with NPT in both groups, and VMCA in the L group was faster than that in the H group at any period. PjvbO2 increased during aortic cross clamp, and decreased on rewarming in both groups. However, there were no significant differences in VMCA and PjvbO2 between the two groups at any period. These findings suggest that increased cerebral blood flow may compensate the decreased oxygen content due to the hemodilution during CPB. Therefore, the profound hemodilution up to 15% of hematocrit is considered to be a safe technique during CPB.     

钢铁生产过程二氧化碳排放计算方法与实践

 钢铁生产过程二氧化碳排放量的精确计算是钢铁行业节能减排的基础。对钢铁生产流程二氧化碳排放的3种常用温室气体排放计算方法进行介绍,并基于A钢厂2014年的生产数据进行计算和分析对比。《省级温室气体清单编制指南》、《钢铁碳排放指南》两种计算方法都是基于投入产出的统计方法,两者温室气体计算结果数值相近,前者吨钢二氧化碳排放结果为2.116 t,后者吨钢二氧化碳排放结果为2.013 t ,后一种方法在计算时考虑了固碳产品的抵扣,所以结果比前种方法结果偏小。基于ISO标准的钢铁产品生命周期计算方法,计算边界从铁矿石、煤炭等原材料的采掘、洗选、运输,焦化,烧结,高炉,炼钢,轧制等直到钢铁产品的出厂,计算结果吨钢产品二氧化碳排放量为2.309 t,相比前两种方法计算结果数值较大,这是因为在计算时包含了铁矿石、煤炭等在开采、洗选、运输阶段产生的二氧化碳。