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.     

Is the Promissory Note of Personality as Vulnerability to Depression in Default? Reply to Zuroff, Mongrain, and Santor (2004).

In contrast to D. C. Zuroff, M. Mongrain, and D. A. Santor (2004), the current authors find the promissory note of dependency-sociotropy (DEP-SOC) and self-criticism-autonomy (SC-AUT) as a model of risk for depression to be in default. The authors propose reorganizing what has been cast as unitary effort into 3 distinct endeavors: a psychoanalytic clinical theory, development of a refined empirical model of risk for clinical depression, and research examining the effects of DEP-SOC and SC-AUT on interpersonal relationships in nonclinical samples. The authors identify some issues that need to be accommodated regardless of whether the assessment of Zuroff et al. (2004) or their own is accepted. DEP-SOC and SC-AUT are best construed as correlated, continuous dimensions. Future work also needs to accommodate depression as chronic recurrent condition, advances in developmental psychopathology, and more stringent criteria for positing a risk factor for clinical disorder. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Normative data for the Wechsler Memory Scale—Revised: 25- to 34-year olds.

The normative data provided in the Wechsler Memory Scale—Revised (WMS—R) manual for individuals aged 25–34 yrs were estimated statistically by interpolation. As an empirical check of this procedure, a representative stratified sample in this age range was selected to match the 1980 US Census data on relevant demographic characteristics. Prorated Full Scale IQs for the group were normally distributed, having a mean of 101.3 (SD?=?14.58, range?=?72–231). Differences between the empirically derived and published index scores appeared to be clinically significant. Substantial intra-individual differences were common when Visual–Verbal or General–Attention/Concentration indexes were compared. Normative data for the WMS—R subtests, indexes, and distribution of differences between indexes is provided. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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.     

Absorption spectra of solid rare earth complexes obtained from the inner filter effect on luminescence

The inner filter effect is observed in luminescence whenever a second substance is present that has absorptions which overlap the luminescence. This results in a diminution of the luminescence at those wavelengths and is generally observed in solution. In the present communication we show that this effect can be observed when a solid rare earth complex is physically mixed with a solid luminescent organic matrix with which it does not interact. The resulting luminescence is reduced in emission intensity at those wavelengths corresponding to the absorptions of the rare earth ion. This is illustrated with a mixture of Na₃[Ho(ODA)₃] ·2NaClO₄·6H₂O and pyrene at 77 K, and it is shown that the absorption spectrum of the holmium complex can be extracted from the luminescence spectrum of pyrene. This absorption spectrum is in good agreement with that obtained by conventional spectroscopy with a single crystal.     

Nuclear Magnetic Resonance Studies of Silicon Carbide Polytypes

The ²⁹Si MAS NMR spectra of the 2H, 4H, 6H, and 3C polytypes of silicon carbide are presented. An attempt is made to correlate differences in the chemical shifts with local atomic environment. The results of the analysis of the spectra of pure polytypes are used as a basic for the interpretation of the spectra of mixed polytypes and a discussion of the crystallinity and impurity levels of different samples. Carbon-13 chemical shifts obtained from spectra of the same polytypes are also tabulated.