Effects of oxygen, positive end-expiratory pressure, and carbon dioxide on oxygen delivery in an animal model of the univentricular heart

OBJECTIVE: Respiratory manipulations are a mainstay of therapy for infants with a univentricular heart, but until recently little experimental information has been available to guide their use. We used an animal model of a univentricular heart to characterize the physiologic effects of a number of commonly used ventilatory treatments, including altering inspired oxygen tension, adding positive end-expiratory pressure, and adding supplemental carbon dioxide to the ventilator circuit. RESULTS: Lowering inspired oxygen tension decreased the ratio of pulmonary to systemic flow. This ratio was 1.29 +/- 0.08 at an inspired oxygen tension of 100%, 0.61 +/- 0.09 at an inspired oxygen tension of 21%, and 0.42 +/- 0.09 at an inspired oxygen tension of 15% (p < 0.05 compared with an inspired oxygen tension of 100% and a positive end-expiratory pressure of 0 cm H2O). High-concentration supplemental carbon dioxide (carbon dioxide tension of 80 to 90 mm Hg) added to the ventilator circuit decreased inspired oxygen tension from 1.29 +/- 0.11 to 0.42 +/- 0.12 (p < 0.05 compared with baseline). A mixture of 95% oxygen and 5% carbon dioxide (carbon dioxide tension of 50 to 60 mm Hg) did not decrease the pulmonary/systemic flow ratio significantly. All three types of interventions influenced systemic oxygen delivery, which was a function of the pulmonary/systemic flow ratio. As the pulmonary/systemic flow ratio decreased from initially high levels (greater than 1), oxygen delivery first increased and reached an optimum at a flow ratio slightly less than 1. As the pulmonary/systemic flow ratio decreased further, below 0.7, oxygen delivery decreased. The ability of systemic arterial and venous oxygen saturations to predict the pulmonary/systemic flow ratio was examined. Venous oxygen saturation correlated well with both pulmonary/systemic flow ratio and systemic oxygen delivery, whereas arterial oxygen saturation did not accurately predict either pulmonary/systemic flow ratio or oxygen delivery. CONCLUSION: This model demonstrated the value of estimating the pulmonary/systemic flow ratio before initiating therapy. When the initial ratio was greater than about 0.7, interventions that decreased the ratio increased oxygen delivery and were beneficial. When the initial pulmonary/systemic flow ratio was below 0.7, interventions that decreased the ratio decreased oxygen delivery and were detrimental. We conclude by presenting a framework to guide therapy based on the combination of arterial and venous oxygen saturations and the estimate of the pulmonary/systemic flow ratio that they provide.     

Compact circular polarised patch antenna with relaxed manufacturing tolerance and improved axial ratio bandwidth

An offset planar fed compact circular polarised microstrip patch antenna is presented. It is found that through the use of embedded star shaped slot loading and an offset planar feed, size reduction of up to 38% can be achieved with no significant reduction in axial ratio bandwidth. It is also found that this design has relaxed manufacturing tolerances.     

Radiation damage effects in tritium implanted Si(Li) detectors

Tritium implanted Si(Li) detectors suffer from the effects of radiation damage during the implantation. These effects are manifested as a pulse height defect and as a broadening of the response function, and thus cause problems in the determination of the tritium beta end-point energy and in the determination of the electron antineutrino mass from the shape of the spectrum near the end point. We use simple models of the trapping of charge carriers to illustrate some of these problems.     

A methodology for learning across application domains for databasedesign systems

Although database design tools have been developed that attempt to automate (or semiautomate) the design process, these tools do not have the capability to capture common sense knowledge about business applications and store it in a context-specific manner. As a result, they rely on the user to provide a great deal of "trivial" details and do not function as well as a human designer who usually has some general knowledge of how an application might work based on his or her common sense knowledge of the real world. Common sense knowledge could be used by a database design system to validate and improve the quality of an existing design or even generate new designs. This requires that context-specific information about different database design applications be stored and generalized into information about specific application domains (e.g., pharmacy, daycare, hospital, university, manufacturing). Such information should be stored at the appropriate level of generality in a hierarchically structured knowledge base so that it can be inherited by the subdomains below. For this to occur, two types of learning must take place. First, knowledge about a particular application domain that is acquired from specific applications within that domain are generalized into a domain node (e.g., entities, relationships, and attributes from various hospital applications are generalized to a hospital node). This is referred to as within domain learning. Second, the information common to two (or more) related application domain nodes is generalized to a higher-level node; for example, knowledge from the car rental and video rental domains may be generalized to a rental node. This is called across domain learning. This paper presents a methodology for learning across different application domains based on a distance measure. The parameters used in this methodology were refined by testing on a set of representative cases; empirical testing provided further validation     

Optimization of the scintigraphic segmental anatomy of the lungs

Accurate and reproducible reporting of lung scintigraphy is predicated on a sound knowledge of the segmental anatomy of the lungs. A limited amount of hard data exists about the true segmental anatomy of the lungs. A virtual model of human lungs was created using a CT-based dataset and a Monte Carlo simulation technique to examine the optimal projections for the visualization of each segment in the lungs. METHODS: Segmental anatomy of the lungs was modeled using CT, cadaveric lungs and standard anatomical texts. The emission, scatter and attenuation of photons was modeled within these virtual lungs and the surrounding tissues. Single segmental lesions were created in eight projections and submitted for blinded reporting to four experienced nuclear medicine physicians to obtain the best views for each segment. RESULTS: The anterior and posterior oblique projections yielded the best views for 10 of 18 segments, with the laterals contributing four views, the anterior contributing two views and the posterior contributing one view. The majority of basal segments (six of nine) were best seen in the anterior and posterior oblique projections. CONCLUSION: This model overcomes the major problems associated with experimentation in the normal human and has the potential to provide answers to the major problems of scatter, attenuation and "shine-through" in lung scintigraphy.     

New polyisobutylene based model ionomers

Three-arm star polyisobutylene ionomers (¯M_n=8800) with terminal SO₃ M (M=K or Ca²) groups were synthesized and their mechanical properties investigated. Compression molded films displayed high elongations, i.e., -1000% for Ca² ionomers with lower values for the K counterions. Strain induced crystallinity was observed at higher elongations. Mechanical properties in general compared favorably with conventional covalently linked rubbery networks and were comparable and in some cases superior to EPDM-based ionomers carrying randomly distributed SO₃ M groups.For the first two parts see Proceedings, 28th IUPAC Macromolecular Symposium, Amherst, MA, July 11–16, 1982, p. 905 and 906     

A Fatal Accident Involving a Glass-Topped Cocktail Table

A 25-year-old male fell backward onto a glass-topped cocktail table causing the untempered glass to break into shards, one of which entered his back causing a fatal injury. To investigate the accident, two exemplar tables were purchased. One of these, like the accident table, had an untempered glass tabletop, while the other had a tabletop which was tempered. The tabletop on each table rested on the table’s iron frame supported by iron tabs at each corner and at the mid-point of each edge. Impact tests were carried out by dropping bags of sand onto the center of a table being tested from a height corresponding to the center of gravity of the accident victim when standing. These tests showed that a 4.54-kg (10-lb) sandbag was sufficient to shatter an untempered tabletop. An 18.14-kg (40-lb) sandbag dropped on a tempered tabletop deformed the frame and mid-point tabs forcing the glass through the frame to the ground without breaking it. It was concluded that the use of untempered glass and other design flaws caused this cocktail table to be an unreasonably dangerous product. The litigation relating to this accident was settled out of court.