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891.
BACKGROUND: Gastrointestinal myoelectric activity during postoperative ileus has been well characterized. However, the common clinical scenario of ileus occurring during and after episodes of sepsis is not well understood. The aim of our study was to determine the effects of a single, sublethal dose of endotoxin on canine gastrointestinal myoelectric activity. METHODS: Eight dogs underwent placement of serosal electrodes on the stomach and small intestine and insertion of a jejunal cannula. After the animals recovered, electrical activity and jejunal mucosal blood flow were determined during fasting and with feeding. Following completion of these baseline studies dogs were given a single, sublethal dose of Escherichia coli lipopolysaccharide (200 g/kg) intravenously, and the studies were repeated daily for 3 consecutive days. RESULTS: Endotoxin resulted in an absence of the interdigestive migrating myoelectric complex for 2 days, a decrease in duodenal and jejunal action potentials during fasting and with feeding, but no decreases in jejunal mucosal blood flow. The gastrointestinal myoelectrical patterns returned to those found in health on postendotoxin day 3. CONCLUSIONS: A single, sublethal dose of endotoxin results in a temporary disruption of gastrointestinal myoelectric activity similar to that seen during postoperative ileus. The etiology of this "adynamic" ileus is unknown but does not appear to be secondary to intestinal ischemia.  相似文献   
892.
A method is described for the determination of radioactivity (microCi or MBq) at an organ site within an object or patient. Using both anatomic image data (CT or MRI scans) and planar gamma camera images, activity at depth is determined using a matrix inversion method based on least squares. The result of the inversion analysis was the unknown set of n linear (uniform) activity densities representative of each organ within the phantom or patient. The problem was overdetermined since the number of unknown activity densities (microCi/cm) was much less than the number of analysis points (N) within the nuclear image. This method, defined as the CT assisted matrix inversion (CAMI) technique, was accurate to within 15% for a three "organ" plastic phantom, wherein the organs were right circular cylinders having activities of 74 to 508 microCi (or 2.74 MBq to 18.8 MBq). This accuracy included image quantitation effects, particularly assumptions concerning attenuation correction. The average absolute percent error of the estimated activity in four distinct radioactive volumes in the phantom was 9.8%. It was found that the background activity within the phantom was estimated to be too high if sampling regions near strong sources were used in the analysis (scatter effect). This was minimized by going at least 2 cm away from such sources. By applying the method to a monoclonal antibody clinical study, activities within the patient's major organs such as liver, spleen, and kidney could be estimated, even in cases where the organ could not be visualized. Here, the CAMI algorithm gave internally consistent results for the patient's left and right lung linear activity concentrations. The CAMI technique resolves the problem of tissue superimposition using depth information from 3-D CT and is applicable in cases where a number of organs overlap in the gamma camera image. Thus, the method should be generally useful to nuclear image quantitation and the estimation of absorbed radiation doses in patients. One particular application is the estimation of radiation doses in radioimmunotherapy (RIT).  相似文献   
893.
We describe results of a 3-year study in which 499 paired venous and capillary blood specimens, collected by fingerstick on the same day, were analyzed for lead (BPb) and erythrocyte protoporphyrin (EP). False-positive rates (FPRs) and the proportion of false positives were calculated at four BPb thresholds. At the 100 microg/L threshold, the FPR for all data was 13%, but the proportion of false positives was only 5%. The log ratios of capillary-to-venous BPb data indicate that, with the exception of eight outliers, two subpopulations exist that follow a log-normal distribution. These two subpopulations, the "core" (n = 303) and "shifted" (n = 188) groups, on average generated a positive bias at 100 microg/L BPb of 8.6% and 30.3%, respectively. The log ratios of capillary-to-venous EP data followed a normal distribution, indicating that capillary EP is not statistically different from venous EP.  相似文献   
894.
Temporary transvenous cardiac pacing requires technical expertise and access to fluoroscopy. We have developed a gastroesophageal electrode capable of atrial and ventricular pacing. The flexible polythene gastroesophageal electrode is passed into the stomach under light sedation. Five ring electrodes, now positioned in the lower esophagus, are used for atrial pacing. A point source (cathode) on the distal tip of the electrode, now positioned in the gastric fundus, is used for ventricular pacing. Two configurations of atrial and ventricular pacing were compared: unipolar and bipolar. During unipolar ventricular pacing the indifferent electrode (anode) was a high impedance chest pad. For bipolar ventricular pacing the indifferent electrode was a ring electrodes placed 2 cm proximal to the tip. Unipolar atrial pacing was performed with 1 of 5 proximal ring electrodes acting as cathode ("cathodic") or as anode ("anodic") in conjunction with a chest pad. Bipolar atrial pacing was performed using combinations of 2 of 5 ring electrodes. Atrial capture was obtained in all 55 subjects attempted. When all electrode combinations were compared, atrial capture was significantly more frequent using the bipolar approach (153/210 bipolar, 65/210 unipolar; t = 7.37, P < 0.001). For unipolar atrial pacing, cathodic stimulation (from esophagus) was more successful than anodic stimulation (cathodic 62/105, anodic 20/105; t = 5.81, P < 0.001). In 43 subjects attempted unipolar ventricular pacing resulted in a higher frequency of capture than the bipolar approach (unipolar 41/43 (95.3%), bipolar 19/43 (44.2%); P < 0.001). In conclusion, atrial pacing was optimal using pairs of ring electrodes ("bipolar") while ventricular pacing was optimal using the distal electrode tip (cathode) in conjunction with a chest pad electrode ("unipolar"). This gastroesophageal electrode may be useful in the emergency management of acute bradyarrhythmias and for elective electrophysiological studies.  相似文献   
895.
The aim of the present experiment was to (i) study the healing after 3 and 7 months of bone defects filled with cancellous bovine bone mineral and (ii) compare the healing around implants placed in normal bone and in defects filled with bovine bone mineral. 5 beagle dogs, about 1-year-old, were used. At baseline, extractions of all mandibular left and right premolars were performed. Bone defects were prepared in the left mandibular quadrant. The defect was immediately filled with natural bovine cancellous bone mineral particles (Bio-Oss, Geistlich Sons Ltd. Wolhusen, Switzerland). No resective surgery was performed in the right jaw quadrant. In both quadrants the flaps were adjusted to allow full coverage of the edentulous ridge and sutured. 3 months later, 2 dogs (group I) were euthanized and biopsies from the premolar regions obtained and prepared for histologic analysis. The 3 remaining dogs (group II) were at this time interval (3 months) subjected to implant installation in the premolar region of both the right and left mandibular jaw quadrants. 2 fixtures of the ITI Dental Implant System (Straumann, Waldenburg, Switzerland; solid-screw; 8 x 3.3 mm) were installed in each side. The fixtures in the test side were placed within the previously grafted defect area, while the fixtures in the control side were placed in normally healed extraction sites. A 4 month period of plaque control was initiated. At the end of this period, a clinical examination including assessment of plaque and soft tissue inflammation was performed and radiographs obtained from the implant sites. Biopsies were harvested and 4 tissue samples were yielded per dog, each including the implant and the surrounding soft and hard peri-implant tissues. The biopsies were processed for ground sectioning or "fracture technique" and the sections produced were subjected to histological examination. The volume of the hard tissue that was occupied by clearly identified Bio-Oss particles was reduced between the 3- and 7-month intervals. This indicates that with time, Bio-Oss becomes integrated and subsequently replaced by newly formed bone. In other words, this xenograft fulfils the criteria of an osteoconductive material. It was also observed that 4 months after implant installation, the titanium/hard tissue interface at test and control sites exhibited, from both a quantitative and qualitative aspect, a similar degree of "osseointegration".  相似文献   
896.
Focal magnetic transcranial stimulation (TCS) is employed for mapping of the motor cortical output to abductor digiti minimi (ADM) muscle. The aim of this study was to evaluate the interhemispheric asymmetries in normals. Motor maps were obtained through motor evoked potentials (MEPs) recordings from ADM muscle in 20 healthy subjects in right and left hemispheres TCS. Measurement of several indexes such as excitability threshold, MEPs amplitude, MEPs latency, and silent period duration did not show differences between the hemispheres. Moreover, no interhemispheric asymmetries were found when the amplitude ratio values were analyzed. The hand motor cortical area, as represented by the number of responsive sites (3.6 vs. 3.5) and the "hot spot" site localization presented a fairly symmetrical organization. Absolute values displayed a relatively wide intersubject variability, while their interhemispheric differences were extremely restricted. This observation can offer a new tool in diagnosing and following up neurological disorders affecting the central motor system, mainly for those concerning monohemispheric lesions.  相似文献   
897.
Discussing sensitive racial and ethnicity issues in the classroom may predispose to heated confrontation if not a legal tangle between the professor and student(s). Students and faculty alike experience uncomfortable feelings in discussing or giving opinions are expressed concerning "isms" (e.g., sexism, socialism, paternalism, feminism, religiosity/spiritualism practices). To minimize the occurrence of this likely situation, implementing a reasoned, systematic mode of discourse is suggested. As a foundation for this approach, modern and contemporary ethical theories are reviewed, and Baldonado's Ethical Decision-Making Paradigm is used to illustrate choosing a morally accepted course of action (act). Implications of culturally sensitivity issues in the classroom, curriculum and nursing practice are presented.  相似文献   
898.
Respiratory support of newborn infants has changed in the last 25 years, because of new knowledge of patho-physiology, controlled studies of respiratory therapy and the realisation of perinatal centers. Respiratory support has changed from the "blow in--suck out" approach, inevitably leading to severe atelectasis, high morbidity and mortality to a now very sophisticated therapy with reduced mortality and morbidity also in very-low-birth-weight infants, who were hopeless patients 25 years ago. Major milestones of this development were the introduction of continuous distending pressure to surfactant deficient lungs, the high-frequency positive pressure ventilation with fine tuning of inspiratory and expiratory times, adjusted to individual time constants and the substitution of artificial surfactant. Techniques for the future, like HFO, NO-inhalation, proportional assist ventilation and liquid ventilation are presently investigated.  相似文献   
899.
Results from particle squashing tests designed to simulate the process of rolled in lubricant debris in rolling element bearings, are presented and showed to compare well with an earlier published theory. Measurements of the harder anvils after squashing various hard particles confirm our earlier theoretical results, that even very soft debris materials can cause plastic deformation in the hard counterfaces.  相似文献   
900.
Processes involved in using SiO2 particles as catalysts for stacked-cup carbon nanotube formation in a spray pyrolysis chemical deposition method from ethanol were investigated. In addition, the recyclability of the SiO2 substrates is investigated. The SiO2 particles are shown to reduce to SiC. Moreover, the addition of triethylborate to produce boron species, and extended reactions, through recycling, leads to higher yields by improving the availability of SiC species. The formation of the carbon nanostructures is best explained through a carbon dissolution mechanism.  相似文献   
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