Clinical and experimental studies of intraoperative autotransfusion using a new filtration device

The Haemocell S-350 device has recently been introduced for intraoperative autotransfusion. The system uses a novel membrane filter to process shed blood. In the first part of this study a 0.2-micron pore size filter was used in a randomized trial comparing the use of autotransfusion (n = 8) with bank blood controls (n = 9) during aortic reconstruction. This part of the trial was abandoned because of unexpected non-surgical bleeding. Bank blood requirements fell from a median of 3.0 (range 0.0-9.0) units to 1.5 (range 0.0-7.0) units when autotransfusion was used, but these patients had a greater perioperative blood loss (1791 (range 932-3104) versus 1140 (range 440-3840) ml). There was evidence of postoperative heparin excess with an activated partial thromboplastin time ratio of 1.3 (range 0.9-3.0) versus 1.0 (range 1.0-1.2) in controls and an activated clotting time of 206 (range 143-280) versus 137 (range 107-142) s. This was confirmed by raised plasma heparin levels and a prolonged thrombin time normalized by protamine. To improve performance a 0.6-micron pore size filter was studied in ten patients. Filtration efficiency doubled from 19 to 38 per cent. Electron micrographs demonstrated better filter clearance, but 44 per cent of the original concentration of heparin remained in the reinfusate. The S-350 device may be an attractive alternative to centrifugation for intraoperative autotransfusion but, until efficiency is improved, it should only be used for cardiovascular surgery when excess heparin can be reversed with protamine.     

Lipid peroxidation and antioxidant system changes in acute L-arginine pancreatitis in rats

The World Wide Web-based form is a promising method for the construction of an on-line data collection system for clinical and epidemiological research. It is, however, laborious to prepare a common gateway interface (CGI) program for each project, which the World Wide Web server needs to handle the submitted data. In medicine, it is even more laborious because the CGI program must check deficits, type, ranges, and logical errors (bad combination of data) of entered data for quality assurance as well as data length and meta-characters of the entered data to enhance the security of the server. We have extended the specification of the hypertext markup language (HTML) form to accommodate information necessary for such data checking and we have developed software named AUTOFORM for this purpose. The software automatically analyzes the extended HTML form and generates the corresponding ordinary HTML form, 'Makefile', and C source of CGI programs. The resultant CGI program checks the entered data through the HTML form, records them in a computer, and returns them to the end-user. AUTOFORM drastically reduces the burden of development of the World Wide Web-based data entry system and allows the CGI programs to be more securely and reliably prepared than had they been written from scratch.     

Estimation of impurity profiles of drugs and related materials: part 19: theme with variations. Identification of impurities in 3-oxosteroids

Due to the varied reactions leading to the 3-oxo group in steroids and the reactivity of its environment, a large number of impurities related to this group are formed during the reaction steps and the degradation studies. In this paper the experiences from the authors laboratory with the 3-oxo-related impurities in 19-nor-4-ene-3-oxosteroids (norgestrel, norethisterone, nandrolone, its esters and Nestorone) as well as corticosteroids (prednisolone, mazipredone, etc) are presented. The impurities include saturated 3-ones, 1-ene-3-ones, 5(10)-ene-3-ones, 3-deoxo and 3-ethinyl-3,5-diene derivatives, 6-ene, 8(14)-ene, 6,8(14)-diene, 6-hydroxy (alpha and beta), 10beta-hydroxy and 6-one derivatives in 4-ene-3-oxosteroids and 8(9)-ene, 9(11)-ene, 11alpha-hydroxy, 11-oxo and 4-ene-3-one derivatives in 11beta-hydroxy-1,4-diene-3-oxosteroids. The chromatographic, spectroscopic and hyphenated techniques used in this study include TLC, GC, HPLC with diode array UV detector, GC-MS, LC-MS and NMR methods.     

Upgrading of gas oils: the HDS kinetics of dibenzothiophene and its derivatives in real gas oil

The hydrodesulphurization (HDS) of dibenzothiophene (DBT), 4-methyl dibenzothiophene (4 M-DBT), 4,6-dimethyl dibenzothiophene (4,6 DM-DBT) and 4,6-diethyl dibenzothiophene (4,6 DE-DBT) as real gas oil components on NiMo/Al₂O₃ catalyst was investigated. On the basis of the first order rate constants of HDS of the individual sulphur compounds reactivities of the investigated compounds decreased in the order DBT ≫ 4 M-DBT > 4,6 DE-DBT ≈ 4,6 DM-DBT. Apparent activation energies of HDS of above sulphur compounds increased from 80.0 to 120.5 kJ/mol.     

Electrodeposition and dissolution of yttrium-hexacyanoferrate layers

The electrodeposition and dissolution of yttrium-hexacyanoferrate [YHCNFe(II)] were investigated by electrochemical quartz crystal microbalance technique (EQCM). The electrodeposition was carried out by potential cycling or stepping from solutions of Y(NO₃)₃ and K₃[Fe^III(CN)₆] of different concentrations. The ratio of the reactants was also varied. No deposition was found in dilute solutions (c < 10⁻³ mol dm⁻³). The increase of concentrations led to an intense deposition of YHCNFe(II) in the course of reduction of [Fe^III(CN)₆]³⁻. At high concentrations of the reactants a coagulation deposition of YHCNFe(III) at open-circuit has also been detected. During the reduction the first phase is the nucleation which requires saturation or oversaturation in respect to the reacting species near the gold surface. The growth phase is much faster than the formation of nuclei, and its rate depends on the concentration and the concentration ratio of the species. The composition of the deposits has been determined by total reflection X-ray fluorescence (TXRF) spectrometry. From the molar ratio of atomic constituents (K, Y and Fe) of the slightly soluble deposit (solubility: 5 × 10⁻⁵ mol dm⁻³) formed after reduction of Fe(III) a formula K_0.46Y_1.18[Fe^II(CN)₆] can be derived. This value is in good accordance with the molar mass calculated from the results of EQCM experiments which also revealed that the deposit contains ca. 2 mol H₂O/mol YHCNFe(II). The solubility of YHCNFe(III) is substantially higher (s = 2 × 10⁻³ mol dm⁻³), and according to the results of TXRF measurements, its composition is Y[Fe^III(CN)₆]. The reoxidation of YHCNFe(II) takes place in two steps. The first one is a partial oxidation which is accompanied by the desorption of K⁺ ions from the layer. During further oxidation a fast dissolution occurs due to the high solubility of YHCNFe(III).     

Identification of Spliceogenic Variants beyond Canonical GT-AG Splice Sites in Hereditary Cancer Genes

Pathogenic/likely pathogenic variants in susceptibility genes that interrupt RNA splicing are a well-documented mechanism of hereditary cancer syndromes development. However, if RNA studies are not performed, most of the variants beyond the canonical GT-AG splice site are characterized as variants of uncertain significance (VUS). To decrease the VUS burden, we have bioinformatically evaluated all novel VUS detected in 732 consecutive patients tested in the routine genetic counseling process. Twelve VUS that were predicted to cause splicing defects were selected for mRNA analysis. Here, we report a functional characterization of 12 variants located beyond the first two intronic nucleotides using RNAseq in APC, ATM, FH, LZTR1, MSH6, PALB2, RAD51C, and TP53 genes. Based on the analysis of mRNA, we have successfully reclassified 50% of investigated variants. 25% of variants were downgraded to likely benign, whereas 25% were upgraded to likely pathogenic leading to improved clinical management of the patient and the family members.     

Manipulation of mental models of anatomy in interventional radiology and its consequences for design of human–computer interaction

Interventional radiology procedures require extensive cognitive processing from the physician. A set of these cognitive functions are aimed to be replaced by technology in order to reduce the cognitive load. However, limited knowledge is available regarding mental processes in interventional radiology. This research focuses on identifying mental model–related processes, in particular during percutaneous procedures, useful to improve image guidance during interventions. Ethnographic studies and a prototype-based study were conducted in order to perform a task analysis and to identify working strategies and cognitive processes. Data were compared to theories from visual imagery. The results indicate a high level of complexity of mental model construction and manipulation, in particular when mentally comparing mental model knowledge with radiology images on screen (e.g., to steer a needle correctly). Regarding current interface support, most difficult is the interpretation and selection of oblique views. New interface principles are needed to bring cognitive demands within reasonable human range, and also accompanying cognitive work strategies should be developed.     

Biocompatibility study of three distinct carbon pastes for application as electrode material in neural stimulations and recordings

Neural interfaces hold great promise for research and treatment of a wide variety of neurological diseases. Medical electrodes are designed to interface with the nervous system and provide control signals for neural prostheses. We fabricated previously a hook-up neural electrode. Here we investigate the in vitro cytotoxicity of three commercial carbon pastes used for printing the conductor tracks of this electrode. At first, the carbon pastes were characterized with respect to their microstructure and chemical composition. SEM images showed a grainy texture that is associated to the carbon/graphite microparticles dispersed by the polymeric binder. All the three pastes contained in major proportions carbon and in different proportions other elements. The surface roughness analysis evidenced differences in the smoothness of the carbon paste surfaces. Sterilization procedures did not alter the microstructure or surface morphology of the pastes. Finally, cell viability based on -(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) test and fluorescence staining experiments proved non-cytotoxicity and suitability of the studied carbon pastes as electrode material for measuring neural activity during surgeries (up to a certain time period).     

Electrochemical corrosion behavior of amorphous carbon nitride thin films

The corrosion behavior along with biocompatibility and mechanical properties plays an important role in determining of biomedical implants feasibility. Diamond-like carbon seems to be the promising material in which all these three requirements can be achieved. In this study nitrogen doped amorphous carbon (a-C:N) films were deposited on silicon and medical CoCrMo alloy substrates by vacuum glow discharge sputtering technique using different deposition conditions from graphite target. Potentiodynamic polarization tests were employed to assess the corrosion performances of the films at room temperature in 0.89 wt. % NaCl solution. The influence of substrate bias on the electrochemical corrosion behavior was investigated. The highest value off E_corr for CoCrMo substrate was measured on the coating deposited with substrate bias around −0.6 kV. The shift of E_corr to more positive values was about 350 mV.     

Effects of monensin on glucose metabolism in transition dairy cows

Eight multiparous periparturient Holstein cows fitted with ruminal cannula were used in a split plot design to evaluate the effects of monensin on plasma glucose metabolism. Diets were top-dressed daily with 0 mg/cow of monensin (control) or 300 mg/cow of monensin (MON) both pre- and postpartum. Plasma glucose kinetic parameters on d ?13 ± 2.0 and 19 ± 1.6 relative to parturition were determined by using stable isotopes. Na-1-¹³C₃-Propionate (labeled propionate) was infused into the rumen to measure glucose synthesis originating from ruminal propionate, and U-¹³C-glucose (labeled glucose) was injected into the jugular vein to determine total glucose kinetics. A sampling period of 480 min following labeled glucose injection was implemented. A compartmental analysis was employed to determine steady state glucose kinetic parameters. To develop a steady state glucose model, the Windows version of SAAM software (WinSAAM) was used. A 4-compartment model was adequate to comprehensively describe plasma glucose metabolism. The main model compartments consisted of propionate and plasma glucose. The time frame of the 480-min sampling period post-tracer glucose infusion allowed accurate quantification of glucose metabolism. The model estimated that glucose input from sources other than ruminal propionate decreased with MON, from 2.26 to 1.09 g/min postpartum. Gluconeogenesis, expressed as the propionate contribution to the plasma glucose pool, increased in cows fed MON (22 vs. 31%), whereas glucose oxidation, expressed as the glucose disposal rate, significantly decreased (1.67 vs. 0.92 g/min). In conclusion, MON may improve the energy status of transition cows by (1) improving the efficiency of propionate to produce glucose and (2) decreasing glucose oxidation in body tissues.