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.     

A new method for the determination of wax precipitation from non-diluted crude oils by fractional precipitation

Wax precipitation is one of the most important flow assurance problems. Unfortunately, experimental data are very scarce to confirm existing models for prediction of such precipitation problem. This work reports a new experimental method. Multistage fractional wax precipitation was carried out by decreasing the temperature of crude oil. No solvent dilution was used, so the effect of solvent on temperature wax precipitation was avoided. The reproducibility of the method was tested with comparable results. The precipitation curve and the wax appearance temperature were obtained for two crude oils with different chemical nature using the reported method.     

Volumetric Curved Planar Reformation for virtual endoscopy

Curved Planar Reformation (CPR) has proved to be a practical and widely used tool for the visualization of curved tubular structures within the human body. It has been useful in medical procedures involving the examination of blood vessels and the spine. However, it is more difficult to use it for large, tubular, structures such as the trachea and the colon because abnormalities may be smaller relative to the size of the structure and may not have such distinct density and shape characteristics. Our new approach improves on this situation by using volume rendering for hollow regions and standard CPR for the surrounding tissue. This effectively combines gray scale contextual information with detailed color information from the area of interest. The approach is successfully used with each of the standard CPR types and the resulting images are promising as an alternative to virtual endoscopy. Because the CPR and the volume rendering are tightly coupled, the projection method used has a significant effect on properties of the volume renderer, such as distortion and isometry. We describe and compare the different CPR projection methods and how they affect the volume rendering process. A version of the algorithm is also presented which makes use of importance driven techniques; this ensures the users attention is always focused on the area of interest and also improves the speed of the algorithm.     

O-Buffer based IFT watershed from markers for large medical datasets

The watershed transform from markers is a very popular image segmentation operator. The image foresting transform (IFT) watershed is a common method to compute the watershed transform from markers using a priority queue, but which can consume too much memory when applied to three-dimensional medical datasets. This is a considerable limitation on the applicability of the IFT watershed, as the size of medical datasets keeps increasing at a faster pace than physical memory technologies develop. This paper presents the O-IFT watershed, a new type of IFT watershed based on the O-Buffer framework, and introduces an efficient data representation which considerably reduces the memory consumption of the algorithm. In addition, this paper introduces the O-Buckets, a new implementation of the priority queue which further reduces the memory consumption of the algorithm. The new O-IFT watershed with O-Buckets allows the application of the watershed transform from markers to large medical datasets.     

Analysis of paraffin precipitation from petroleum mixtures by means of DSC: Iterative procedure considering solid-liquid equilibrium equations

Wax deposition is a well known flow assurance risk in crude oil production due to temperature decrease which depends mainly on the crude oil nature and the type and content of paraffin. The prevention of this problem requires a detailed characterization of the crude oil and the availability of reliable predictive models.The experimental determination and quantification of the precipitation process is quite complex and time consuming and simpler techniques are of interest to carry out such study. Among them, differential scanning calorimetry (DSC) technique is appropriate to develop routine essays and has been extensively applied to determine wax appearance temperature in crude oil and fractions because the simplicity and fast response of the technique.However, the determination of wax precipitation curve from a quantitative DSC interpretation is usually based on pure n-alkane properties and involves some difficulties. In this work, a new procedure has been developed including the effect of the fluid composition on the precipitation temperature and the melting heat. Solid-liquid equilibrium equations were introduced through a simplified thermodynamic model in the integration procedure resulting in an iterative method combining experimental and calculated values. The final method yields the wax appearance temperature (WAT), the full wax precipitation curve and the estimated wax composition.In order to validate the procedure, several crude oil fractions were used as standards due to the advantage of a narrow n-alkane distribution. Experimental characterization for the cloud point temperature, the n-alkane distribution (determined by gas chromatography with mass detector, GCMS) and DSC was carried out. The agreement between experimental results and those obtained from the DSC interpretation is a good check for the proposed procedure.     

Metal profiles used as environmental markers of green turtle (Chelonia mydas) foraging resources

The Baja California Peninsula, Mexico serves an important role for feeding and developing sea turtles. High concentrations of metals detected in green turtles (Chelonia mydas) from Magdalena Bay prompted an investigation into the sources of metals in the region. We compared metal concentrations in sea turtle tissues with plant species found in their stomach contents, and with the same species of plants collected inside a sea turtle refuge area known as Estero Banderitas. Differences in the metal concentrations between marine plant species were minimal. Principal components analysis of the percent contribution of individual metals to the overall metal signature of each plant or tissue sample generated three principal components that explained 80.7% of the total variance in the data. The plant samples collected within Estero Banderitas formed a separate grouping from the green turtle tissue samples and the plants from the stomach contents. The plants in the stomach contents contained greater percent contributions of Cd and Zn than the plants collected inside the bay, while Pb and Mn contributed more to the metal profiles in the bay samples. The metal profiles in the sea turtle tissues more closely resembled the stomach contents than the same species of plants collected within Estero Banderitas, and suggest that sea turtles collected inside Magdalena Bay use foraging resources outside of the Estero Banderitas region. This work supports the suggestion that metal profiles can be used as "environmentally acquired markers" to improve our understanding of the extent of sea turtle foraging areas.     

In vitro antiphagocytic effect of Melia azedarach leaf extracts on mouse peritoneal exudate cells

The first reported case of cerebellar metastasis from primary clear cell adenocarcinoma of the fallopian tube is presented. Initially diagnosed as stage Ia, the patient underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy and omentectomy, followed by cisplatin-based chemotherapy and whole pelvic irradiation. Thirty six months later multiple pulmonary metastases were detected that did not respond to chemotherapy. Later the patient presented with cerebellar metastasis. She received whole brain radiotherapy and steroids. The brain lesion partially responded and the patient's neurologic symptoms improved. Throughout there was no evidence of local recurrence. This case suggests that with the prolonged survival achieved by aggressive treatment occult brain metastases might become apparent.     

Urethral protrusion caused by blunt trauma of the anterior urethra

We report an uncommon case of complete rupture of the anterior urethra secondary to blunt trauma, with protrusion of the urethral mucosa through the urinary meatus. The singular images of this case are presented and the mechanisms involved in this unusual type of lesion are analyzed.     

Molecular dynamics study of the influence of functionalization on the elastic properties of single and multiwall carbon nanotubes

The effect of carboxylation on axial Young’s modulus of carbon nanotubes is investigated using a molecular dynamics (MD) approach. COMPASS force field is used to model the interatomic interactions in single wall (SWCNT) and multiwall carbon (MWCNT) with different amounts of –COOH groups attached to their surfaces. The results of the MD simulations show how an increase of the number of carboxylic groups on the CNT surface leads to a decrease on the Young moduli of the CNTs. The decrease of MWCNT Young’s modulus is found to be lower than in the case of SWCNT.