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Lactate clearance and survival following injury 总被引:1,自引:0,他引:1
D Abramson TM Scalea R Hitchcock SZ Trooskin SM Henry J Greenspan 《Canadian Metallurgical Quarterly》1993,35(4):584-8; discussion 588-9
Previous reports cite optimization of O2 delivery (DO2) to 660 mL/min/m2, O2 consumption (VO2) to 170 mL/min/m2, and cardiac index (CI) of 4.5 L/min as predicting survival. We prospectively evaluated 76 consecutive patients with multiple trauma admitted directly to the ICU from the operating room or emergency department. Patients had serum lactate levels and oxygen transport measured on ICU admission and at 8, 16, 24, 36, and 48 hours. Patients were analyzed with respect to survival (S) versus nonsurvival (NS), lactate clearance to normal (< or = 2 mmol/L) by 24 and 48 hours, hemodynamic optimization as defined above, as well as Injury Severity Score (ISS), ICU stay (LOS), and admission blood pressure. All patients achieved non-flow-dependent VO2. There was no difference in CI, DO2, VO2, or ISS when S was compared with NS. All 27 patients whose lactate level normalized in 24 hours survived. If lactate levels cleared to normal between 24 and 48 hours, the survival rate was 75%. Only 3 of the 22 patients who did not clear their lactate level to normal by 48 hours survived. Ten of the 25 nonsurvivors (40%) achieved the above arbitrary optimization criteria. Fifteen of the survivors never achieved any of these criteria. Optimization alone does not predict survival. However, the time needed to normalize serum lactate levels is an important prognostic factor for survival in severely injured patients. 相似文献
3.
The pharmacokinetic and pharmacodynamic effects of vaginal rings releasing levonorgestrel (L-NOG) at an initial rate of 27 micrograms/24 h were studied in a group of 12 normally menstruating women during 90 days of continuous use (i.e., during three 30-day treatment segments). Blood samples were drawn immediately before insertion, 15 and 30 min, as well as 1, 2, 4, 8, 12 and 24 h after insertion of the rings, and thereafter three times weekly throughout the study for the analysis of L-NOG, estradiol, progesterone and sex hormone-binding globulin (SHBG). Endometrial biopsies were obtained for a morphometric analysis in a pre-treatment (control) cycle and in the 6th and 10th weeks of treatment. The peak of average L-NOG levels was reached within two hours after the insertion of rings. Until 24 h after insertion, the levels did not change significantly. Thereafter, a decrease at a rate of 0.2% per day was initiated. The L-NOG and SHBG levels were highly correlated. This was seen for both the pre-treatment SHBG vs L-NOG (r = 0.96) and the treatment SHBG vs L-NOG levels (r = 0.92). There was a significant (p < 0.001) decrease of SHBG levels due to treatment. During the total of 36 treatment segments, a normal ovarian function was seen in 47% of the segments. The women were anovulatory and had an inadequate lutal function in 28% and 25% of segments, respectively. No correlation between the L-NOG levels and ovarian reaction to treatment was found. The use of L-NOG induced significant changes in the endometrium; the number of glands/mm2 decreased after 6 (p < 0.02) and 10 weeks of use (p < 0.01). Also, the diameter of glands and the occurrence of vacuolated cells decreased significantly (p < 0.02 and p < 0.005, respectively). None of the endometrial parameters or dating was correlated with the ovarian reaction to treatment, indicating independent endometrial effects of L-NOG. 相似文献
4.
SZ Zhou S Cooper LY Kang L Ruggieri S Heimfeld A Srivastava HE Broxmeyer 《Canadian Metallurgical Quarterly》1994,179(6):1867-1875
Recombinant adeno-associated virus 2 (AAV) virions were constructed containing a gene for resistance to neomycin (neoR), under the control of either the herpesvirus thymidine kinase (TK) gene promoter (vTK-Neo), or the human parvovirus B19 p6 promoter (vB19-Neo), as well as those containing an upstream erythroid cell-specific enhancer (HS-2) from the locus control region of the human beta-globin gene cluster (vHS2-TK-Neo; vHS2-B19-Neo). These recombinant virions were used to infect either low density or highly enriched populations of CD34+ cells isolated from human umbilical cord blood. In clonogenic assays initiated with cells infected with the different recombinant AAV-Neo virions, equivalent high frequency transduction of the neoR gene into slow-cycling multipotential, erythroid, and granulocyte/macrophage (GM) progenitor cells, including those with high proliferative potential, was obtained without prestimulation with growth factors, indicating that these immature and mature hematopoietic progenitor cells were susceptible to infection by the recombinant AAV virions. Successful transduction did not require and was not enhanced by prestimulation of these cell populations with cytokines. The functional activity of the transduced neo gene was evident by the development of resistance to the drug G418, a neomycin analogue. Individual high and low proliferative colony-forming unit (CFU)-GM, burst-forming unit-erythroid, and CFU-granulocyte erythroid macrophage megakaryocyte colonies from mock-infected, or the recombinant virus-infected cultures were subjected to polymerase chain reaction analysis using a neo-specific synthetic oligonucleotide primer pair. A 276-bp DNA fragment that hybridized with a neo-specific DNA probe on Southern blots was only detected in those colonies cloned from the recombinant virus-infected cells, indicating stable integration of the transduced neo gene. These studies suggest that parvovirus-based vectors may prove to be a useful alternative to the more commonly used retroviral vectors for high efficiency gene transfer into slow or noncycling primitive hematopoietic progenitor cells, without the need for growth factor stimulation, which could potentially lead to differentiation of these cells before transplantation. 相似文献
5.
BK Park ES Cho JD Lee C Oh MS Lee SZ Kim SH Kim KW Cho 《Canadian Metallurgical Quarterly》1998,43(8):611-618
The effect of a naturally occurring plant phenolic constituent (the acylphloroglucinol derivative, jensenone, derived from Eucalyptus jensenii) on the food intake of two folivorous marsupials, the common ringtail (Pseudocheirus peregrinus) and the common brushtail possum (Trichosurus vulpecula) was studied. When fed diets containing varying concentrations of jensenone, both species regulated their intake of jensenone so as not to exceed a ceiling intake. This ceiling was about twice as high for common ringtails as for common brushtails from northern Australia. Southern populations of common ringtails showed greatly reduced capacities to tolerate jensenone. When common brushtails were injected (0.5 mg.kg-0.75 body mass) with ondansetron (a selective antagonist of serotonin 5HT3 receptors), they ate significantly more jensenone than animals injected with physiological saline. The same pattern was observed when common ringtails were fed diets containing both jensenone and ondansetron (0.0035 mg.g-1 wet mass of diet). Ondansetron injection had no effect on food intake when the food did not contain jensenone while the addition of higher doses of ondansetron to diets of common ringtails very slightly reduced food intakes of a non-jensenone diet. When common brushtails were given 50 mg of jensenone by gastric lavage, their average subsequent intake of dietary jensenone matched the difference between the daily threshold and the dose given, although the response of individuals was highly variable. Lavage with water alone had no effect on subsequent jensenone intake compared with the pre-dose period. We interpret these results as evidence that the antifeedant effects of jensenone and related compounds are partly mediated by serotonin action on 5HT3 receptors most likely via "nausea" to condition a food aversion. 相似文献
6.
Antibody microarrays are gaining popularity as a high-throughput technology to investigate the proteome. However, protein extracts from most body fluid or biopsy samples are available in very small volumes and are often unsuitable for large-scale antibody microarray studies. To demonstrate the potential for protein analysis with as little as a few nanoliters of sample, we have developed a new technology called NanoProbeArrays based on piezoelectric liquid dispensing for non-contact printing and probing of antibody arrays. Instead of flooding the protein sample on the antibody microarray surface, as in conventional microarray screening, a piezoelectric inkjet printer is used to dispense nanoliters of fluorescently labeled proteins over the antibody spots on the array. The ability of NanoProbeArrays to precisely identify and reliably distinguish between test proteins from different sources, without any loss of sensitivity and specificity as compared with conventional antibody microarrays, is illustrated here. The utility of NanoProbeArrays for biomarker identification in a complex biological sample was tested by detecting the cytokine interleukin-4 in serum. The significant reduction in volume of sample during NanoProbeArray analysis, as compared with conventional antibody microarrays, offers new opportunities for basic and applied proteomic research. 相似文献
7.
Widely used electron beam welding machines are equipped with heavy power supplies, located in a special oil tank and connected with an electron gun to a high-voltage cable. A special system detects electric discharges in the electron gun space, which may arise during welding and then it tries to switch off the high voltage to interrupt an electric arc. Such disadvantages have been eliminated with the novel power supply described here. The Q of resonance circuit of this supply is stabilized and as a result circulating power appears. During an electric discharge in the gun, power is not sent to the electron gun but circulates between the electronic parts of the resonance circuit without losses and “waits” for the break in the short circuit. The power supply is much smaller and lighter than supplies of similar rating used nowadays. It is connected directly to the electron gun chamber without a high-voltage cable. The first construction of the supply was designed for electron beam welding machine of 5 kW power and 60 kV accelerating voltage. Tests of the new power supply in laboratory and industrial conditions have shown its usefulness for electron beam welding. 相似文献
8.
Katarzyna Matkiewicz Agnieszka Bukowska Wiktor Bukowski 《Journal of Inorganic and Organometallic Polymers and Materials》2012,22(2):332-341
Hydroxyl functionalized gel type resins derived from 2-hydroxyethyl, 2-hydroxypropyl and 2-hydroxy-3-phenoxypropyl methacrylates
were applied to covalent immobilization of Mn(salen) complexes via glutarate and carbonate linkers. The obtained catalysts
were characterized by FTIR and DR UV–Vis methods and elemental analysis. It was found that the activity of polymeric catalysts
obtained in this way depended on both the nature of the functional and cross-linking monomers and the degree of the cross-linking
of polymer matrices and the way of complex immobilization. The highest activity was observed for the complexes immobilized
on the HEMA resins cross-linked with 3%-mol of diethylene glycol dimethacrylate. For instance, in the presence of the catalysts
with (S,S)-salen ligand S-epoxystyrene and (1S, 2R)-epoxyindene could be obtained with 46% and 69% ee, respectively. Attempts
have also been made to recycle the selected catalyst. However, a rapid fall off in the activity was observed, although the
selectivity was similar in which three cycles. 相似文献
9.
10.
Agnieszka Bukowska Wiktor Bukowski 《Journal of chemical technology and biotechnology (Oxford, Oxfordshire : 1986)》1996,67(2):176-182
The kinetics of the reaction between acetic acid and epichlorohydrin in the presence of chromium acetate and chromic anhydride have been studied. The isolation method revealed the reagents reacted with partial orders. A reduction of chromium from the oxidation level +6 to +3 has been observed when chromic anhydride was used as catalyst. A mathematical model for the overall process has been developed and the mechanism of reaction discussed. 相似文献