Changes of indices of the oxygen-transport state, depending on periodization of the ischemic cerebral stroke

Objective. To elaborate a clinico-pathogenetic periodization of ischemic cerebral stroke, depending on changes of the oxygen-transport state indices in critically ill patents, suffering the ischemic cerebral stroke on background of conduction of complex intensive therapy. Materials and methods. Into the investigation 75 patients, suffering ischemic cerebral stroke, ageing 41 - 77 yrs, were included, in whom the indices of oxygen-transport state and severity of neurological symptoms on background of complex intensive therapy were studied. Depending on severity of neurologic symptoms, three similar groups of patients were formed (25 patients in every one), suffering mild, middle-severe and severe ischemic cerebral stroke, in which the disease severity was determined in accordance to the National Institute of Health Stroke Scale. Results. On background of the complex intensive therapy conduction the duration of the most acute period in mild ischemic stroke have constituted 3 days, in a middle-severe - 4 days, and in a severe one - 7 days. Tendency towards minimization of neurologic deficiency was noted, if parameters of central hemodynamics, the oxygen budget and the cognition level were stabilized during 2 days. Simultaneously the cardiac index values for all groups of patients have been situated in a range of (2.99 ± 0.20) l × min-1 × m-2, the oxygen delivery index have exceeded (509 ± 34) ml × min-1 × m-2. The restored level of neurological symptoms have not a tendency towards improvement or was stable during several days in accordance to data of the National Institute of Health Stroke Scale. The restored level of neurological symptoms had a tendency to improvement or staying during several days stable in accordance to indices of scales of National Institute of Health and Comas Glasgow, than a progressive staged improvement began. Conclusion. Normalization during 2 days of the oxygen-transport state indices without neurological symptoms progression constitutes a criterion of conclusion of the most acute period of the disease in patients, suffering mild, middle-severe and severe ischemic cerebral stroke. The restored due to intensive therapy during 48 h the oxygen-transport state without progressing of neurological symptoms in patients, suffering ischemic cerebral stroke, witnesses lowering of the cerebral tissue oedema and restoration of the autoregulation processes

Periodization of the brain ischemic insult

Periodization of the brain ischemic insul

Differentiated approach to treatment of arterial hypertension in patients, suffering ischemic cerebral stroke

Objective. To raise the efficacy of treatment of arterial hypertension in patients, suffering ischemic cerebral stroke of the middle grade of severity on background of determination of hemodynamic variant of arterial hypertension. Materials and methods. Prospective nonrandomized investigation concerning 42 patients, suffering ischemic cerebral stroke of middle severity in accordance to the insult severity scale of National Institute of Health (National Institutes of Health Stroke Scale - NIHSS), was conducted. The patients’ middle age have constituted (69.4 ± 1.4) yrs. There were the central hemodynamic indices measured, the arterial hypertension hemodynamic variant determined, the oxygen and hemodynamic status estimated, and in accordance to the results obtained - the differentiated antihypertensive therapy was administered. All the patients were divided into three groups, depending on hemodynamical variant of arterial hypertension: the first group – patients with eukinetic variant, the second group – patients with hypokinetic variant, the third group – patients with hyperkinetic variant. Hemodynamical variant of arterial hypertension was determined in accordance to the referent level of cardiac index. The groups were representative in accordance to age, height, the body mass, the main and concurrent pathology and the cerebral affection degree. Results. In the patients, suffering initial eukinetic hemodynamical variant of arterial hypertension, the cardiac index have fluctuated from 2.88 to 4.67 l × min-1 × m-2, general peripheral vascular resistance have rested in the norm borders, the oxygen saturation level of arterial blood did not demand the oxygen therapy, index of the oxygen delivery have exceeded the appropriate values and fluctuated in borders from 541 to 903 l × min-1 × m-2. In complex of differentiated antihypertensive therapy there was applied a constant intravenous injection of magnesium sulfate in a daily dose 2500 - 5000 mg. For patients with initial hypokinetic hemodynamic variant of arterial hypertension following signs are characteristic: low cardiac index - from 1.65 to 2.08 l × min-1 × m-2, the enhanced general peripheral vascular resistance - 2813 (from 2393 to 3403) dyne × s-1 × cm-5 and the lowered index of the oxygen delivery - from 306 to 412 l × min-1 × m-2. Differentiated antihypertensive therapy was conducted, using urapidyl: intravenous boluses 1.25 – 2.5 mg with further infusion 5 - 40 mg × h-1. For hyperkinetic hemodynamic variant of arterial hypertension the raised cardiac index is characteristic – 3.75 l × min-1 × m-2 (fluctuated in borders from 3.62 to 4.10 l × min-1 × m-2), as well as normal general peripheral vascular resistance - 1189 (from 1055 to 1449) dyne × s-1 × cm-5 and raised index of the oxygen delivery - 762 (from 725 to 828) l × min-1 × m-2. Differentiated antihypertensive therapy was conducted, using labetalol: intravenous infusion with velocity 2 - 8 mg × min-1. Conclusion. In the patients with ischemic cerebral stroke of the middle grade of severity the conduction of differentiated antihypertensive therapy, taking into account hemodynamic type of arterial hypertension and the oxygen-hemodynamic stabilization of the blood circulation system, improved the results of treatment and accelerated the rehabilitation duration

Integrative monitoring of systemic hemodynamics and the oxygen-transport status and the choice of the intensive therapy tactics in patients, suffering an ischemic cerebral insult

Objective. To elaborate the intensive therapy tactic in patients, suffering ischemic cerebral insult (ICI) depending on changes in the systemic hemodynamics indices and the oxygen-transportation status.Маterials and methods. In 42 patients, suffering the ICI of middle severity, ageing 45 - 88 years old, the integrative monitoring of the neurological state severity, systemic hemodynamics indices and the oxygen-transportation status on background of targeted intensive therapy was conducted. Results. In the patients, suffering initial hypoxemia, a hypokinetic heart index (HI) - (2,0±0,1) l×min-1×m-2 and the lowered systemic delivery of oxygen (DO2) - (356±21) ml×min-1×m-2were revealed. Prophylactic oxygenation is needed if the value of the oxygen content in arterial blood (SаO2) exceeds 95% and DO2 is lesser than 520 ml×min-1×m-2. Aiming the achievement of eukinetic values of the HI, correction of vascular spasm and antihypertensive therapy was conducted, using alpha-adrenoblocking agent (urapydil) up to stabilization of the DO2 indices on the level of 520-600 ml×min-1×m-2. In hyperoxidal state a hyperkinetic HI - (3.6±0.1) l×min-1×m-2 and a raised DO2 - (699±14) ml×min-1×m-2 were revealed. Prophylactic oxygenation is not indicated if the value of the SаO2 index exceeds 95% and DO2 exceeds 600 ml×min-1×m-2. Aiming to achieve eukinetic values of HI it is mandatory to conduct antihypertensive therapy, using therapy with аlpha-beta-аdrenoblocking agent (labetalol). Conclusion. Targeted intensive therapy, oriented towards balance with general oxygenation of the organism tissues, normalizes the oxygen-transport homeostasis in shortest terms, what impacts the results of treatment in patients, suffering ICI, immediately

CAD-Based Shielding Analysis for ITER Port Diagnostics

Radiation shielding analysis conducted in support of design development of the contemporary diagnostic systems integrated inside the ITER ports is relied on the use of CAD models. This paper presents the CAD-based MCNP Monte Carlo radiation transport and activation analyses for the Diagnostic Upper and Equatorial Port Plugs (UPP #3 and EPP #8, #17). The creation process of the complicated 3D MCNP models of the diagnostics systems was substantially accelerated by application of the CAD-to-MCNP converter programs MCAM and McCad. High performance computing resources of the Helios supercomputer allowed to speed-up the MCNP parallel transport calculations with the MPI/OpenMP interface. The found shielding solutions could be universal, reducing ports R&D costs. The shield block behind the Tritium and Deposit Monitor (TDM) optical box was added to study its influence on Shut-Down Dose Rate (SDDR) in Port Interspace (PI) of EPP#17. Influence of neutron streaming along the Lost Alpha Monitor (LAM) on the neutron energy spectra calculated in the Tangential Neutron Spectrometer (TNS) of EPP#8. For the UPP#3 with Charge eXchange Recombination Spectroscopy (CXRS-core), an excessive neutron streaming along the CXRS shutter, which should be prevented in further design iteration

Strong resonances at high excitation energy in 17O+alpha resonance scattering

The Thick Target Inverse Kinematic (TTIK) approach was used to measure excitation functions for the elastic 17O ({\alpha}, {\alpha}) scattering at the initial 17O beam energy of 54.4 MeV. We observed strong peaks corresponding to highly excited {\alpha}-cluster states in the 21Ne excitation energy region of 8-16 MeV, which have never been investigated before. Additional tests were done at a 17O beam energy of 56.4 MeV to estimate a possible contribution of resonance inelastic scattering.Comment: 6 pages,3 figures, conference pape

Four-dimensional distribution of the 2010 Eyjafjallajökull volcanic cloud over Europe observed by EARLINET

© Author(s) 2013. This work is distributed under the Creative Commons Attribution 3.0 License.The eruption of the Icelandic volcano Eyjafjallaj ökull in April-May 2010 represents a "natural experiment" to study the impact of volcanic emissions on a continental scale. For the first time, quantitative data about the presence, altitude, and layering of the volcanic cloud, in conjunction with optical information, are available for most parts of Europe derived from the observations by the European Aerosol Research Lidar NETwork (EARLINET). Based on multi-wavelength Raman lidar systems, EARLINET is the only instrument worldwide that is able to provide dense time series of high-quality optical data to be used for aerosol typing and for the retrieval of particle microphysical properties as a function of altitude. In this work we show the four-dimensional (4-D) distribution of the Eyjafjallajökull volcanic cloud in the troposphere over Europe as observed by EARLINET during the entire volcanic event (15 April-26 May 2010). All optical properties directly measured (backscatter, extinction, and particle linear depolarization ratio) are stored in the EARLINET database available at www.earlinet.org. A specific relational database providing the volcanic mask over Europe, realized ad hoc for this specific event, has been developed and is available on request at www.earlinet.org. During the first days after the eruption, volcanic particles were detected over Central Europe within a wide range of altitudes, from the upper troposphere down to the local planetary boundary layer (PBL). After 19 April 2010, volcanic particles were detected over southern and south-eastern Europe. During the first half of May (5-15 May), material emitted by the Eyjafjallajökull volcano was detected over Spain and Portugal and then over the Mediterranean and the Balkans. The last observations of the event were recorded until 25 May in Central Europe and in the Eastern Mediterranean area. The 4-D distribution of volcanic aerosol layering and optical properties on European scale reported here provides an unprecedented data set for evaluating satellite data and aerosol dispersion models for this kind of volcanic events.Peer reviewe

Crossing the Dripline to 11N Using Elastic Resonance Scattering

The level structure of the unbound nucleus 11N has been studied by 10C+p elastic resonance scattering in inverse geometry with the LISE3 spectrometer at GANIL, using a 10C beam with an energy of 9.0 MeV/u. An additional measurement was done at the A1200 spectrometer at MSU. The excitation function above the 10C+p threshold has been determined up to 5 MeV. A potential-model analysis revealed three resonance states at energies 1.27 (+0.18-0.05) MeV (Gamma=1.44 +-0.2 MeV), 2.01(+0.15-0.05) MeV, (Gamma=0.84 +-$0.2 MeV) and 3.75(+-0.05) MeV, (Gamma=0.60 +-0.05 MeV) with the spin-parity assignments I(pi) =1/2+, 1/2- and 5/2+, respectively. Hence, 11N is shown to have a ground state parity inversion completely analogous to its mirror partner, 11Be. A narrow resonance in the excitation function at 4.33 (+-0.05) MeV was also observed and assigned spin-parity 3/2-.Comment: 14 pages, 9 figures, twocolumn Accepted for publication in PR

Study of Proton and Deuteron Pickup Reactions 2H(10Be,3He)9Li an 2H(10Be,4He)8Li with 44 A MeV 10Be Radioactive Beam at ACCULINNA-2 Fragment Separator

The proton and deuteron pickup reactions 2H(10Be,3He)9Li and\\ 2H(10Be,4He)8Li radioactive beam produced by the new fragment separator ACCULINNA-2 at FLNR, JINR\@. These measurements were initially motivated as test reactions intended for the elucidation of results obtained in the study of the extremely neutron-rich 7H and 6H systems created in the 2H(10Be,3He)9Li and 2H(10Be,4He)8Li reactions using the same setup. In the 2H(10Be,3He)9Li reaction the 9Li ground-state ($3/2^-$) and its first excited state (2.69~MeV, $1/2^-$) were identified in the low-energy region of its excitation spectrum. The differential cross sections for the 9Li g.~s.) population were extracted at forward center-of-mass angles ($3^\circ-13^\circ$) and compared with the FRESCO calculations. Spectroscopic factor of $\sim 1.7$, derived by a model for the 10Be$= p +$9Li(g.s.) clustering was found in accord with the experimental data. The energy spectrum of 8Li populated in the 2H(10Be,4He)8Li reaction shows the strong peak which corresponds to excitation of the second excited state of 8Li (2.25 MeV, $3^+$). The fact that the ground and the first excited states of 8Li were not observed is fully consistent with Shell-Model calculations carried out for the 10Be g.\,s. and 8Li level structure applying momentum selection rules