Changes in plasma levels of B-type natriuretic peptide with acute exacerbations of chronic obstructive pulmonary disease.

Background: Elevated plasma B-type natriuretic peptide (BNP) levels and their association with heart failure have been reported in subjects with acute exacerbations of chronic obstructive pulmonary disease (AECOPD). Purpose: To examine and compare plasma BNP levels and diastolic and systolic dysfunction in subjects with AECOPD and s table chronic obstructive pulmonary disease (COPD). Methods: In all,87 unselected consecutive hospitalizations due to AECOPD in 61 subjects and a total of 190 consecutive subjects with stable COPD were recruited. Plasma BNP levels were compared cross-sectionally and longitudinally. Transthoracic echocardiographic examinations were also performed in the hospitalized subjects. Results: In the hospitalized subjects, the median plasma BNP level (interquartile range) was 55.4 (26.9–129.3) pg/mL and was higher than that of patients with stable COPD: 18.3 (10.0–45.3)for Global Initiative for Chronic Obstructive Lung Disease grade I; 25.8 (11.0–53.7) for grade II; 22.1 (9.1–52.6) for grade III; and 17.2 (9.6–22.9) pg/mL for grade IV, all P,0.001. In 15 subjects studied prospectively, the median plasma BNP level was 19.4 (9.8–32.2) pg/mL before AECOPD, 72.7 (27.7–146.3) pg/mL during AECOPD, and 14.6 (12.9–39.0) pg/mL after AECOPD (P,0.0033 and P,0.0013, respectively). Median plasma BNP levels during AECOPD were significantly higher in ten unsuccessfully discharged subjects 260.5 (59.4–555.0) than in 48 successfully discharged subjects 48.5(24.2–104.0) pg/mL (P=0.0066). Only 5.6% of AECOPD subjects were associated with systolic dysfunction defined as a left ventricular ejection fraction (LVEF),50%; a further 7.4% were considered to have impaired relaxation defined as an E/A wave velocity ratio,0.8 and a deceleration time of E.240 ms. BNP levels were weakly correlated with the E/peak early diastolic velocity of the mitral annulus (Ea) ratio (Spearman’s rank correlation coefficient =0.353,P =0.018), but they were not correlated with the LVEF (Spearman’s rank correlation coefficient =−0.221,P = 0.108). Conclusion: A modest elevation of plasma BNP is observed during AECOPD. It appears that AECOPD may have an impact on plasma BNP levels that is not attributable to heart failure

Rapid Thermal Processing (RTP) of semiconductors in space

The progress achieved on the project entitled 'Rapid Thermal Processing of Semiconductors in Space' for a 12 month period of activity ending March 31, 1993 is summarized. The activity of this group is being performed under the direct auspices of the ROMPS program. The main objective of this program is to develop and demonstrate the use of advanced robotics in space with rapid thermal process (RTP) of semiconductors providing the test technology. Rapid thermal processing is an ideal processing step for demonstration purposes since it encompasses many of the characteristics of other processes used in solid state device manufacturing. Furthermore, a low thermal budget is becoming more important in existing manufacturing practice, while a low thermal budget is critical to successful processing in space. A secondary objective of this project is to determine the influence of microgravity on the rapid thermal process for a variety of operating modes. In many instances, this involves one or more fluid phases. The advancement of microgravity processing science is an important ancillary objective