Analyses of coronary graft patency after aprotinin use: results from the International Multicenter Aprotinin Graft Patency Experience (IMAGE) trial

OBJECTIVE: We examined the effects of aprotinin on graft patency, prevalence of myocardial infarction, and blood loss in patients undergoing primary coronary surgery with cardiopulmonary bypass. METHODS: Patients from 13 international sites were randomized to receive intraoperative aprotinin (n = 436) or placebo (n = 434). Graft angiography was obtained a mean of 10.8 days after the operation. Electrocardiograms, cardiac enzymes, and blood loss and replacement were evaluated. RESULTS: In 796 assessable patients, aprotinin reduced thoracic drainage volume by 43% (P < .0001) and requirement for red blood cell administration by 49% (P < .0001). Among 703 patients with assessable saphenous vein grafts, occlusions occurred in 15.4% of aprotinin-treated patients and 10.9% of patients receiving placebo (P = .03). After we had adjusted for risk factors associated with vein graft occlusion, the aprotinin versus placebo risk ratio decreased from 1.7 to 1.05 (90% confidence interval, 0.6 to 1.8). These factors included female gender, lack of prior aspirin therapy, small and poor distal vessel quality, and possibly use of aprotinin-treated blood as excised vein perfusate. At United States sites, patients had characteristics more favorable for graft patency, and occlusions occurred in 9.4% of the aprotinin group and 9.5% of the placebo group (P = .72). At Danish and Israeli sites, where patients had more adverse characteristics, occlusions occurred in 23.0% of aprotinin- and 12.4% of placebo-treated patients (P = .01). Aprotinin did not affect the occurrence of myocardial infarction (aprotinin: 2.9%; placebo: 3.8%) or mortality (aprotinin: 1.4%; placebo: 1.6%). CONCLUSIONS: In this study, the probability of early vein graft occlusion was increased by aprotinin, but this outcome was promoted by multiple risk factors for graft occlusion.     

Parallel source separation system for heart and lung sounds

The Journal of Supercomputing - In this paper, we propose a parallel source separation system designed to extract heart and lung sounds from single-channel mixtures. The proposed system is based on...     

A comparison study of wavelet transforms for the visualization of differentially methylated regions in DNA samples

The Journal of Supercomputing - DNA methylation analysis has become an important topic in the study of human health. DNA methylation analysis requires not only a specific treatment of DNA samples...     

An XPS and reduction study of PrCoO3

The perovskite-type oxide PrCoO₃ has been studied by means of X-ray photoelectron spectroscopy (XPS), reduction in H₂ and X-ray diffraction. Two types of oxygen were detected: lattice oxygen (binding energy = 528.4 eV) and adsorbed oxygen (binding energy = 530.9 eV). The increase in relative intensity of the peak corresponding to the latter species after reduction of PrCo0₃ to 3e^– per molecule is assigned to the formation of hydroxyl groups. Temperature-programmed reduction (TPR) results showed two reduction steps: to 1 e^– per molecule (Co^3.1 Co²⁺) at 475 to 635 K, and to 3e^– per molecule (Co²¹ Co⁰) at 725 to 815 K. Reduction in the first and second steps occurs according to the contracting sphere model and the nucleation mechanism, respectively. Reduction of Co³⁺ to Co²⁺ causes minimal structural changes in the perovskite. Reduction to 3e^– per molecule yielded Pr₂O₃ and metallic cobalt. After this reduction and reoxidation at 973 K, the perovskite structure was regained. By XPS and TPR it was shown that PrCo0₃ is more easily reducible than LaCo0₃. It is concluded that the cation in the A position of the structure plays a significant role in the bulk and surface properties of LnCo0₃ (Ln, lanthanide elements) oxides.     

Influence of the stress,strain, and temperature on the surface roughness of an AlSl 52100 steel due to an orthogonal cut

In recent years, the finite element method (FEM) has become the main tool for simulating the metal cutting process because research based on trial and error is time consuming and requires high investment. Early studies were done by different investigators. In this research AISI 52100, hardened steel (62 HRC) was selected for an orthogonal machining process as well as metal cutting simulation using the software DEFORM-2D. This software is based on a forging process and has been adapted to an orthogonal machining process. The results of simulated cutting forces were compared with experimental cutting force data to validate the orthogonal cut simulation. Also, the surface roughness was measured, and the influence of the stress, strain, and temperature on the surface roughness was studied.     

Cu/SBA-15 as adsorbent for propane/propylene separation

Samples of mesoporous silica SBA-15 were prepared under hydrothermal conditions where Cu cations were incorporated to the structure by impregnation in order to compare the adsorption behavior in the presence and absence of this element. The adsorption/desorption equilibrium isotherms of propylene, propane, and N₂ were measured to evaluate their usefulness in the propane/propylene separation. All the adsorption isotherms of SBA-15 measured in the absence of Cu cations were described by the Freundlich equation, while the adsorption isotherms of propane on Cu/SBA-15 were better represented by the Henry equation and those of propylene were satisfactorily described by the Langmuir model in the range P < 100 Torr. The adsorption uptake of propylene increased and that of propane decreased in Cu/SBA-15 as compared to the amounts observed in the SBA-15 sample. The presence of Cu atoms in the adsorbent lattice increased the selectivity towards propylene. Under some working conditions the adsorbed amount of propylene in Cu/SBA-15 sample was totally reversible and the propane uptake, negligible.