Объемная капнография как способ оценки эффективности альвеолярной вентиляции в клинической практике

The purpose of the study was to compare the relationship between the dead space volume and tidal volume (VD/VT) using volumetric capnography (VCap) during pressure controlled (PCV) and pressure supported (PSV) ventilation mode in the postoperative period.Materials and methods. 30 randomly assigned cardiac surgical patients undergoing CABG (coronary artery bypass grafting) using ECC (extracorporeal circuit) were included in an observational, prospective study. Patients were connected to the ventilator immediately after ICU admission. After that, monitoring VD/VT, CO2 production (VECO2) as well as ventilation parameters was carried out. The parameters during PCV and PSV mode were statistically evaluated using t-test.Results. Expiratory CO2 (ETCO2) concentration were not significantly different in both PCV or PSV (p=NS), although both VECO2 and minute ventilation (MV) increased during PSV mode (p<0.01). VD/VT in PSV mode was lower than in PCV. Gas exchange represented by alveolar ventilation (VA) was better during PSV (p<0.01). VA was also higher during PSV (p<0.05). The calculated VD/VT ratio differed between PCV and PSV mode (p<0.01).Conclusion. VCap represents a tool for monitoring of CO2 exchange effectivness. We registered a decrease in VD/VT with improved alveolar ventilation (VA) in PSV mode. VCap seems to be a suitable instrument for adjustment of protective lung ventilation.Цель исследования — сравнить взаимосвязь между объемом мертвого пространства и дыхательным объемом (VD/VT) методом объемной капнографии (VCap) в режимах искусственной вентиляции легких с управляемым давлением (PCV) и поддержкой давлением (PSV) в послеоперационном периоде.Материалы и методы. В обсервационное, проспективное исследование методом случайного выбора включили 30 пациентов из отделения сердечно-сосудистой хирургии, перенесших операцию аортокоронарного шунтирования (АКШ) с экстракорпоральным кровообращением. Пациентов подключали к системе вентиляции легких сразу при поступлении в отделение интенсивной терапии. Затем проводили мониторинг VD/VT, продукции CO2 (VECO2), а также параметров вентиляции. Параметры вентиляции в режимах с управляемым давлением (PCV) и поддержкой давлением (PSV) статистически оценивалиРезультаты. Не выявили достоверных различий концентрации CO2 во выдыхаемом воздухе (ETCO2) между режимами PCV и PSV (p=NS), хотя как VECO2, так и минутная вентиляция (MV) возрастали в режиме PSV (p<0,01). Отношение VD/VT в режиме PSV было ниже, чем в режиме PCV. Газообмен, представленный альвеолярной вентиляцией (VA), был лучше в режиме PSV (p<0,01). Показатель VA был также выше в режиме PSV (p<0,05). Расчетное отношение VD/VT различалось между режимами PCV и PSV (p<0,01).Заключение. Объемная капнография (VCap) является средством мониторинга эффективности обмена CO2. Отмечали снижение VD/VT с улучшением альвеолярной вентиляции (VA) в режиме PSV. VCap представляется подходящим методом регулирования протективной вентиляции легких

Drug interaction with T-cell receptors: T-cell receptor density determines degree of cross-reactivity

Background: Immune-mediated adverse reactions to drugs are often due to T-cell reactivity, and cross-reactivity is an important problem in pharmacotherapy. Objective: We investigated whether chemical inert drugs can stimulate T cells through their T-cell receptor (TCR) and analyzed the cross-reactivities to related compounds. Methods: We transfected human TCRs isolated from two drug-reactive T-cell clones (TCCs) by PCR into a TCR-negative mouse T-cell hybridoma. The TCCs were isolated from a patient with drug hypersensitivity to the antibacterial sulfonamide sulfamethoxazole (SMX). Results: The transfectants reacted to SMX only in the presence of antigen-presenting cells (APCs). Glutaraldehyde-fixed APCs, however, were sufficient to elicit T-cell stimulation, indicating a processing-independent direct interaction of the drug with the TCR and MHC molecule. The transfected hybridomas secreted IL-2 in a drug dose-dependent manner, whereas the degree of reactivity was dependent on the level of TCR expression. One transfectant reacted not only to SMX but also to related sulfonamide compounds. Interestingly, high TCR expression increased cross-reactivity to other structurally related compounds. In addition, SMX-specific TCR cross-reacted only with sulfonamides bearing a sulfanilamide core structure but not with sulfonamides such as celecoxib, furosemide, or glibenclamide. Conclusions: These results demonstrate that the T-cell reactivity to drugs is solely determined by the TCR. Moreover, these results show that cross-reactivity of structurally similar compounds correlates with the density of the TCR. Stably transfected T-cell hybridomas may represent a powerful screening tool for cross-reactivity of newly generated sulfonamide-containing compounds such as celecoxib

From waste to valuable cosmetic raw material: the valorization of coffee silverskin following the approach of circular economy

Coffee silverskin (CS) is a tegument of coffee beans that constitutes a by-product of the roasting process. CS has no commercial value and is currently discarded as a solid waste. CS chemical composition can be broken up into cellulose, lignin, proteins, lipids and phenolic compounds, each of which has a great potentiality as a raw material in many fields, included cosmetics. The aim of the work is to selectively extract the lipid and the phenolic fractions from CS and to study their use as functional and active ingredients in cosmetic formulations. This project is part of a bigger program named CirCo (Circular Coffee), focused on the valorization of this residue of agro-food industry, not only in cosmetics, but also for innovative and sustainable solutions in paper production. CirCo involves different academic and industrial research groups and aims at creating a model that embraces the increasingly emerging circular economy approach, practicing industrial symbiosis, waste-to-resource vision and life cycle thinking. CS extracts are obtained using supercritical fluid extraction (SFE), obtaining a promising lipid fraction. The compound is a semisolid brownish material and shows a peculiar composition of fatty acids, with a significant amount of C20:0 and C22:0. The organoleptic and the chemico-physical properties of the resulting lipid fraction are firstly assessed. Its chemical composition is determined by means of fatty acid and unsaponifiable matter analyses. Volatile content analysis, FT-IR, DSC and GPC are used to acquire further technical data. Chemico-physical characterization is targeted on one side to assess the safety and the regulatory compliance, on the other side to classify the lipid fraction in terms of cosmetic properties. A stability study is then performed on the raw material to define its oxidation stability and shelf life, while compatibilities with other ingredients are carried out to guide the formulation. Based on the results obtained, the most suitable formulations are selected to generate prototypal make-up products using the lipid fraction of silverskin. The underway scale-up of the extraction from lab to pilot scale confirms the extraction protocol and guarantees the needed amount of materials for formulating new cosmetic products. The choice to valorize a residue of agro-food industry for different applications, the adoption of a promising and green process such as SFE, the network created among reaserch groups of academia and industry are virtuous elements useful to explore how far we are from a complete sustainable industrial development, where environment, business, quality and safety standards need to fit the same big picture

Volumetric Сapnography As a Tool for Evaluation of Alveolar Ventilation Effectiveness in Clinical Practice

The purpose of the study was to compare the relationship between the dead space volume and tidal volume (VD/VT) using volumetric capnography (VCap) during pressure controlled (PCV) and pressure supported (PSV) ventilation mode in the postoperative period.Materials and methods. 30 randomly assigned cardiac surgical patients undergoing CABG (coronary artery bypass grafting) using ECC (extracorporeal circuit) were included in an observational, prospective study. Patients were connected to the ventilator immediately after ICU admission. After that, monitoring VD/VT, CO2 production (VECO2) as well as ventilation parameters was carried out. The parameters during PCV and PSV mode were statistically evaluated using t-test.Results. Expiratory CO2 (ETCO2) concentration were not significantly different in both PCV or PSV (p=NS), although both VECO2 and minute ventilation (MV) increased during PSV mode (p<0.01). VD/VT in PSV mode was lower than in PCV. Gas exchange represented by alveolar ventilation (VA) was better during PSV (p<0.01). VA was also higher during PSV (p<0.05). The calculated VD/VT ratio differed between PCV and PSV mode (p<0.01).Conclusion. VCap represents a tool for monitoring of CO2 exchange effectivness. We registered a decrease in VD/VT with improved alveolar ventilation (VA) in PSV mode. VCap seems to be a suitable instrument for adjustment of protective lung ventilation

JESSI project: advanced technolgoy for 0.25 #mu#m CMOS and below. Subproject: process modules evaluation and integration. Theme 5 Multilevel metallization. Final report

Titanium- and cobaltdisilicide were investigated as material for shallow, low-resistive contacts in a CMOS-metallization system. ITM and DDS were used as self-aligned manufacturing processes. The TiSi_2- and CoSi_2-contact-systems were compared concerning manufacturing process and electrical and physical properties. The CoSi_2-contact-system shows the best properties. CVD-W was used to fill up vias and interconnects. To this a selective tungsten CVD process on CoSi_2 and a blanket deposition process were developed. Due to the excellent selectivity concerning the contact filling, a planarization effect was achieved. Accelerated tests show a high current-carrying capacity for the interconnects. Electromigration was identified as degradation mechanism. PECVD- and TEOS-PECVD-processes were investigated for the deposition of intermetal-dielectrics. An electrical and physical characterization of the layers have been performed. Processes with good step coverage and processes with a planarization effect were specified. Etch-back procedures using photo-resist and spin-on-techniques with various polyimides and a spin-on-glass were investigated in view of a planarization of the chip surface. The best results were achieved using the spin-on-technique with polyimide. (orig.)SIGLEAvailable from TIB Hannover: F94B1507+a+b / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekBundesministerium fuer Forschung und Technologie (BMFT), Bonn (Germany)DEGerman