Impact of an Interleukin-1 Receptor Antagonist and Erythropoietin on Experimental Myocardial Ischemia/Reperfusion Injury

Background. Revascularization of infarcted myocardium results in release of inflammatory cytokines mediating myocardial reperfusion injury and heart failure. Blockage of inflammatory pathways dampens myocardial injury and reduces infarct size. We compared the impact of the interleukin-1 receptor antagonist Anakinra and erythropoietin on myocardial ischemia/reperfusion injury. In contrast to others, we hypothesized that drug administration prior to reperfusion reduces myocardial damage. Methods and Results. 12–15 week-old Lewis rats were subjected to myocardial ischemia by a 1 hr occlusion of the left anterior descending coronary artery. After 15 min of ischemia, a single shot of Anakinra (2 mg/kg body weight (bw)) or erythropoietin (5000 IE/kg bw) was administered intravenously. In contrast to erythropoietin, Anakinra decreased infarct size (P < 0.05, N = 4/group) and troponin T levels (P < 0.05, N = 4/group). Conclusion. One-time intravenous administration of Anakinra prior to myocardial reperfusion reduces infarct size in experimental ischemia/reperfusion injury. Thus, Anakinra may represent a treatment option in myocardial infarction prior to revascularization

Percutaneous aortic valve replacement: valvuloplasty studies in vitro

Objective: Valvuloplasty of the aortic valve is currently used in selected patients for severe calcified aortic valve disease, but clinical effectiveness is low and complication rate remains high. In this study, the total particle load after valvuloplasty and the embolization risk of calcific debris into the coronary arteries was analyzed in an in vitro model. Methods: Three highly calcified human aortic leaflets have been sutured into a porcine annulus (N=9). Both coronary arteries were separated and each was anastomized to a silicon line, which was drained off into a measuring beaker. Then valvuloplasty was performed (Thyshak II, 20mm, 1.5atm). After removal of the balloon, 100ml of sodium chloride solution irrigated the ascending aorta. After passing through the separated coronary arteries, the solution was filtered (filter size 0.45μm), dried, and the total amount of particles was analyzed microscopically. Results: Nine experiments were analyzed. After valvuloplasty, all hearts showed a median of 18 particles larger than 1mm in the coronary arteries (range 0-307). The amount of particles smaller than 1mm was 6574 (median, range 2207-14200). In five cases, coronary arteries were completely occluded by bulky particles. Conclusion: This study demonstrated a large amount of calcific particles after valvuloplasty with a consequently high risk for coronary embolic events in case of highly calcified aortic valves. In times of valvuloplasty rediscovering as part of transcatheter valve implantation, the risk of embolization should be taken into consideration and filtering techniques have to be develope

Why are naturally ventilated office spaces not popular in New Zealand?

In this paper, we investigated the reason(s) why natural ventilation is not as popular as air-conditioned or mixed-mode ventilation systems in Green-rated office buildings in New Zealand. To achieve this, we had three objectives. Firstly, we reviewed the Green Star criteria for thermal comfort in office buildings to ascertain which ventilation system the NZ Green Star rating tool promotes. Secondly, we ascertained the perception of occupants in office buildings regarding thermal comfort. This was followed by an interview with building experts regarding factors that affect the use of natural ventilation in New Zealand offices. The findings showed that the NZ Green Star thermal comfort criteria encourage the use of mechanical ventilation over natural ventilation which results in designers opting for air conditioning systems in office designs. We observed that occupants of naturally ventilated spaces were least satisfied with the thermal comfort of their offices when compared with occupants of mixed-mode and air-conditioned offices. This study fulfils the need to encourage the use of natural ventilation in office environments by designers and building owners. Further study on other aspects of the indoor environment quality that is related to naturally ventilated systems such as lighting and noise is required in a bid to ascertain its viability in office environments

A non-recurrent inferior laryngeal nerve in a man undergoing thyroidectomy: a case report

<p>Abstract</p> <p>Introduction</p> <p>A non-recurrent variant of the inferior laryngeal nerve has been seldom reported. These reports are mostly based on cadaveric dissection studies or large chart review studies in which the emphasis is placed on the determination of the frequency of the variation, and not on the clinical appearance of this variant. We graphically describe the intraoperative identification of a non-recurrent inferior laryngeal nerve.</p> <p>Case Presentation</p> <p>A 44-year old Caucasian man was referred to the Head and Neck Surgery Outpatient Clinic with the diagnosis of a nodular mass in his left thyroid lobe that had been growing for one year. A fine needle aspiration puncture was compatible with thyroid papillary cancer. It was decided that the patient should undergo total thyroidectomy. During surgery, a non-recurrent right inferior laryngeal nerve was noted. This nerve emanated from the right vagus nerve, entering the larynx 3 cm after its origin. The nerve did not show a recurrent course. The nerve on the left side had a normal configuration. The surgery and post-operative period were uneventful, and the patient had no change in his voice.</p> <p>Conclusion</p> <p>This paper allows those interested to become acquainted with the normal intraoperative appearance of a non-recurrent inferior laryngeal nerve. This will undoubtedly be of significance for all of those performing invasive diagnostic and surgical procedures in the neck and upper thoracic regions, in order to minimize the risk of iatrogenic injury to this nerve. This is of extreme importance, since a unilateral lesion of this nerve may result in permanent hoarseness, and a bilateral lesion may lead to aphonia and life-threatening dyspnea.</p

Evaluating daylighting effectiveness and occupant visual comfort in a side-lit open-plan office building in San Francisco, California

The introduction of daylight to reduce electrical lighting energy consumption and to enhance Indoor Environmental Quality is one of the most common claims made for commercial office buildings promoted as “sustainable,” “energy efficient,” “green,” or “high performance.”  However, daylit buildings are rarely studied in use to examine the impact of design strategies on visual comfort, or to examine how occupant modifications to the facade may reduce daylighting effectiveness and visual connection to the outdoors.   This paper presents key findings from a post-occupancy study of a side-lit open-plan office building located in San Francisco, California.  The study examines daylighting performance over daily and seasonal changes in sun and sky conditions in core and perimeter zones of the building.  Daylighting performance is assessed through measurements of electrical lighting energy, observations of occupant modifications to the facade, and physical measurements of interior lighting conditions paired with occupant subjective assessments using novel desktop polling station devices.  Results show a high frequency of visual discomfort responses at both perimeter and core workspaces and observations reveal a large percentage of facade glazing covered by interior shading devices.   Despite the significant reduction in effective visible light transmission, occupants working in the perimeter zones generally considered the levels of available daylight to be sufficient, even when daylight levels were below recommended thresholds for daylight autonomy.  Issues related to the daylighting design strategies are discussed in regard to improving the performance of future daylit buildings and refining daylighting design criteria

Green architecture : advanced technologies and materials

xiii, 352 p. ; 25 cm

Green architecture advanced technologies and materials

xiii+352hlm.;24c