Hemodynamic changes in patients developing effective hypovolemia after total paracentesis

BACKGROUND/AIMS: In many centers paracentesis is considered the treatment of choice for tense ascites. However, the mechanism of effective hypovolemia after paracentesis, the main complication associated with this procedure, remains unknown. In the current study, systemic hemodynamics was sequentially studied before and after total paracentesis in 46 patients with cirrhosis and tense ascites. The aim of the study was to assess the mechanism of effective hypovolemia after paracentesis. METHODS: Plasma renin activity and aldosterone, mean arterial pressure, cardiac output (ECO-Doppler) and systemic vascular resistance were measured before, and 3 h, 6 h and 6 days after total paracentesis associated with plasma volume expansion. RESULTS: Effective hypovolemia after paracentesis (defined as 50% increase in plasma renin activity up to a level over 4 ng x m(-1) x h(-1) at the 6th day after paracentesis) occurred in 20 cases [plasma renin activity increased from 8+/-17 to 19+/-2.7 ng x m(-1) x h(-1)]. In the remaining 26 cases no changes in plasma renin activity [8.5+/-2.4 vs. 8.7+/-2.2 ng x m(-1) x h(-1)] were observed. The amounts of ascitic fluid volume removed were similar. Effective hypovolemia after paracentesis was associated with a significant decrease in mean arterial pressure (89+/-2 vs. 81+/-3 mmHg) and systemic vascular resistance [1263+/-67 vs. 1014+/-80 dyn x s(-1) x cm(-5)] 6 days after treatment. In contrast, no significant changes in these parameters were observed in patients not developing this complication. In the whole group of patients a significant inverse relation was observed between changes in plasma renin activity and in systemic vascular resistance (r=0.74;p< 0.001). CONCLUSIONS: These results indicate that effective hypovolemia after paracentesis in cirrhosis is predominantly due to an accentuation of the arteriolar vasodilation already present in these patients.     

A new class of intelligent knowledge-based systems with an optimisation-based inference engine

In this paper we describe a new class of intelligent knowledge-based system (IKBS) which can be used principally for managerial decision making applications. This class of applications often requires a framework for knowledge acquisition which allows the system to use the knowledge of several experts. In addition, since in most business decision making the objective is maximise profits, there is a need for an inference engine which allows optimisation to be carried out. The new class of IKBS which is described in this paper has both these properties, i.e., the ability to use the knowledge of multiple experts in a convenient way and an inference engine which by performing optimisations is able to pick out the profit maximising decisions. As an illustration of these concepts, a system for allocation decision making is described. The system ‘Retail-opt’ allows the user to solve problems like allocation of space in retail outlets, allocation of space in mail order catalogues, pricing policy decisions for discounted airline tickets, etc. In the paper, the basic concepts behind ‘Retail-opt’ are described and an application of ‘Retail-opt’ to the problem of retail space allocation in a Scandinavian Department Store is given. A number of other systems which use these concepts for more complicated competitive decision making situations are also described.     

Solid state chemistry of Ruddlesden-Popper type complex oxides

Various criteria of formation of perovskites and K₂NiF₄-type compounds, which are the end members of homologous Ruddlesden-Popper series of phases, have been discussed. RP-phases show some general trends in their physical properties. Literature survey of the formation of these phases, their properties, and effect of oxygen stoichiometry and doping is presented. Some conditions for their synthesis are also described.     

Simonization for signal design

Ternary sequences have been searched earlier with good merit factor or alternatively good discrimination as the search criterion. When one of these measures is a search criterion, the other measure takes generally a poor value. As both of them are quantifications of the abstract notion of a sequence with peaky autocorrelation, it is better to look for sequences with good values of merit factor and discrimination simultaneously, without optimizing either measure. This is called Simonization. Simonized ternary sequences are listed.     

An MLP-based model for identifying qEEG in depression

Manual differentiation of electroencephalography (EEG) paper recordings in cases of depression is not very helpful. So, a Multilayer Perceptron (MLP) has been used to differentiate the EEG power density spectra (qEEG) in the wakeful state from animals (control, exercised and depressed). The qEEG ranging from 1 to 30 Hz, at 1 Hz increments (30 input features) and also a slow, medium and fast activity (represented by three ranges of frequencies at the input) were used. After training with depressed and control qEEG only, the MLP has been found to distinguish successfully between the normal and the depressed rats in more than 80% of the cases, identifying, in the process, most of the exercised groups' EEG as normal. The reduction in the dimension of input features from 30 individual frequencies to 3 frequency bands has produced similar results. The rules generated for making such distinctions have been found to be similar to the clinical views.     

Serum concentrations of soluble adhesion molecules in patients with colorectal cancer

The concentrations of the soluble adhesion molecules E-cadherin, E-selectin, intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) were investigated in 48 patients with colorectal cancer before treatment, and their relation to clinical, histological and routine laboratory parameters was examined. Data were collected on tumour stage at presentation, presence and sites of metastatic disease, tumour pathology and results of routine laboratory tests. Serum concentrations of ICAM-1 and VCAM-1 were significantly elevated in the patients with colorectal cancer in comparison with a group of healthy subjects (P < 0.00001). Levels of circulating ICAM-1 and VCAM-1 were increased both in patients with local and those with metastatic disease. Although elevated in some patients soluble E-cadherin and E-selectin concentrations were not significantly elevated compared with the control group (P = 0.71 and P = 0.052 respectively). The levels of circulating ICAM-1 were significantly correlated with those of VCAM-1 and E-selectin. A correlation was also found between the serum concentrations of E-selectin and ICAM-1 and alkaline phosphatase, total white cell count and platelet count. VCAM-1 was positively correlated with age and negatively with degree of tumour differentiation and haemoglobin concentration. The biological implications and possible clinical relevance of these findings are discussed.     

Taste agnosia following gustatory neocortex ablation: Dissociation from odor and generality across taste qualities.

In Exp I, 18 male Long-Evans hooded rats trained to avoid drinking in the presence of a compound odor (benzyl acetate) and taste (sucrose) CS lost the taste habit but retained the odor habit following gustatory neocortex (GN) ablation. Conversely, olfactory bulb ablation resulted in loss of the odor habit but retention of the taste habit. In Exp II, with 60 Ss, Ss lacking GN did not retain preoperatively instated learned aversions to a suprathreshold quinine hydrochloride (bitter) taste solution that had been employed as a CS. However, Ss with GN lesions that were virtually identical to those of the bitter-trained group retained a preoperatively learned aversion to a hydrochloric acid (sour) CS. Exp III, with 60 Ss, demonstrated that reliable agnosia for an acid CS could be produced by lesions that extended more deeply into perirhinal areas near the claustrum at the level of the GN. It is concluded that the agnosia following GN ablation is relatively specific to gustation and that agnosia for preoperatively acquired tasted aversion habits occurs for all 4 basic gustatory stimuli following anterolateral cortex ablations centered on the GN. (49 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

THE EFFECT OF ASPHALT COMPOSITION ON THE FORMATION OF ASPHALTENES AND THEIR CONTRIBUTION TO ASPHALT VISCOSITY

Interactions among asphalt components have significant effects on the performance of asphalt binder. To understand those interactions, four asphalts, SHRP AAA-I, AAD-I, AAF-I, and AAG-I, were fractionated into three generic fractions according to Corbett's procedure and reblended into asphaltenes/aromatics/saturates ternary mixtures in various ratios. Mixtures were oxidatively aged with atmospheric air at temperatures of 87.7, 93.3, and 98.8°C for 5 to 33 days. The changes in chemical composition and physical properties were monitored using fourier transform infrared spectroscopy (FT-IR) and dynamic mechanical rheometry

The formation of asphaltenes is a major factor in the hardening of asphalt with aging. The data collected in this study indicate that the saturate content in the maltene phase has a profound impact on the contribution that asphaltenes have on the viscosity of aged asphalt. The data also suggest that the aromatics fraction is solely responsible for the formation of asphaltenes as an asphalt oxidizes.