Influence of high-dose aprotinin treatment on blood loss and coagulation patterns in open-heart surgery

Intraoperative administration of the proteinase Inhibitor aprotinin causes reduction in blood loss and homologous blood requirement in patients undergoing cardiac surgery. To ascertain the blood-saving effect of aprotinin and to obtain further information about the mode of action, 40 patients undergoing primary myocardial revascularization were randomly assigned to receive either aprotinin or placebo treatment. Aprotinin was given as a bolus of 2 X 105 kallikrein inactivator units (KIU) before surgery followed by a continuous infusion of 5 X 105 KIU/h during surgery. Additionally, 2 X 105 KIU were added to the pump prime. Strict criteria were used to obtain a homogeneous patient selection. Total blood loss was reduced from 1,431 +/- 760 ml in the control group to 738 +/- 411 ml in the aprotinin group (P < 0.05) and the homologous blood requirement from 838 +/- 963 ml to 163 +/- 308 ml (P < 0.05). In the control group, 2.3 +/- 2.2 U of homologous blood or blood products were given, and in the aprotinin group, 0.63 +/- 0.96 U were given (P < 0.05). Twenty-five percent of patients in the control group and 63% in the aprotinin group did not receive banked blood or homologous blood products. The activated clotting time as an indicator of inhibition of the contact phase of coagulation was significantly Increased before heparinization in the aprotinin group (141 +/- 13 s vs. 122 +/- 25 s) and remained significantly Increased until heparin was neutralized after cardiopulmonary bypass (CPB). The concentration of the thrombin-antithrombin III complex was significantly decreased at the end of CPB in the aprotinin group, indicating less thrombin generation in the aprotinin-treated group. The total concentration of the fibrinogen-fibrin split products (FSP) and the split products of the cross-linked fibrin (D-dimers) were also significantly reduced due to attenuated proteolytic activities of thrombin and plasmin. The results of the fibrin plate assay revealed higher fibrinolytic activity during CPB in the control group. The results demonstrate the beneficial effect of high-dose aprotinin treatment on blood loss and homologous blood requirement. This effect can be attributed to the inhibition of the contact phase of coagulation and the consequently reduced thrombotic and fibrionolytic activity during and after CPB

The relaxation dynamics of a simple glass former confined in a pore

We use molecular dynamics computer simulations to investigate the relaxation dynamics of a binary Lennard-Jones liquid confined in a narrow pore. We find that the average dynamics is strongly influenced by the confinement in that time correlation functions are much more stretched than in the bulk. By investigating the dynamics of the particles as a function of their distance from the wall, we can show that this stretching is due to a strong dependence of the relaxation time on this distance, i.e. that the dynamics is spatially very heterogeneous. In particular we find that the typical relaxation time of the particles close to the wall is orders of magnitude larger than the one of particles in the center of the pore.Comment: 9 pages of Latex, 4 figure

Modus Vivendi Beyond the Social Contract: Peace, Justice, and Survival in Realist Political Theory

This essay examines the promise of the notion of modus vivendi for realist political theory. I interpret recent theories of modus vivendi as affirming the priority of peace over justice, and explore several ways of making sense of this idea. I proceed to identify two key problems for modus vivendi theory, so conceived. Normatively speaking, it remains unclear how this approach can sustain a realist critique of Rawlsian theorizing about justice while avoiding a Hobbesian endorsement of absolutism. And conceptually, the theory remains wedded to a key feature of social contract theory: political order is conceived as based on agreement. This construes the horizontal tensions among individual or group agents in society as prior to the vertical, authoritative relations between authorities and their subjects. Political authority thereby appears from the start as a solution to societal conflict, rather than a problem in itself. I argue that this way of framing the issue abstracts from political experience. Instead I attempt to rethink the notion of modus vivendi from within the lived experience of political conflict, as oriented not primarily toward peace, but political survival. With this shift of perspective, the idea of modus vivendi shows us, pace Bernard Williams, that the “first political question” is not how to achieve order and stability, but rather: what can I live with

Magnetic instability in a sheared azimuthal flow

We study the magneto-rotational instability of an incompressible flow which rotates with angular velocity Omega(r)=a+b/r^2 where r is the radius and $a$ and b are constants. We find that an applied magnetic field destabilises the flow, in agreement with the results of Rudiger & Zhang 2001. We extend the investigation in the region of parameter space which is Rayleigh stable. We also study the instability at values of magnetic Prandtl number which are much larger and smaller than Rudiger & Zhang. Large magnetic Prandtl numbers are motivated by their possible relevance in the central region of galaxies (Kulsrud & Anderson 1992). In this regime we find that increasing the magnetic Prandtl number greatly enhances the instability; the stability boundary drops below the Rayleigh line and tends toward the solid body rotation line. Very small magnetic Prandtl numbers are motivated by the current MHD dynamo experiments performed using liquid sodium and gallium. Our finding in this regime confirms Rudiger & Zhang's conjecture that the linear magneto-rotational instability and the nonlinear hydrodynamical instability (Richard & Zahn 1999) take place at Reynolds numbers of the same order of magnitude.Comment: 4 pages, 4 figure

Turbulent states in plane Couette flow with rotation

Shearing and rotational forces in fluids can significantly alter the transport of momentum.A numerical investigation was undertaken to study the role of these forces using plane Couette flow subject to rotation about an axis perpendicular to both wall-normal and streamwise directions. Using a set of progressively higher Reynolds numbers up to Re = 5200, we find that the torque for a given Re is a non-monotonic function of rotation number, Ro. For low-to-moderate turbulent Reynolds numbers we find a maximum that is associated with flow fields that are dominated by downstream vortices and calculations of 2-d vortices capture the maximum also quantitatively. For higher shear Reynolds numbers a second stronger maximum emerges at smaller rotation numbers, closer to non-rotating plane Couette flow. It is carried by flows with a markedly 3-d structure and cannot be captured by 2-d vortex studies. As the Reynolds number increases, this maximum becomes stronger and eventually overtakes the one associated with the 2-d flow state.Comment: 15 pages, 10 figure

A Wire-Based Methodology to Analyse the Nanometric Resolution of an RF Cavity BPM

Resonant Cavity Beam Position Monitors (RF-BPMs) are diagnostic instruments capable of achieving beam position resolutions down to the nanometre scale. To date, their nanometric resolution capabilities have been predicted by simulation and verified through beam-based measurements with particle beams. In the frame of the PACMAN project at CERN, an innovative methodology has been developed to directly observe signal variations corresponding to nanometric displacements of the BPM cavity with respect to a conductive stretched wire. The cavity BPM of this R&D study operates at the TM110 dipole mode frequency of 15GHz. The concepts and details of the RF stretched wire BPM testbench to achieve the best resolution results are presented, along with the required control hardware and software

AVALIAÇÃO DOS EFEITOS DO CARVEDILOL NO REMODELAMENTO CARDÍACO EM CÃES COM MIOCARDIOPATIA DILATADA

Dilated cardiomyopathy in dogs is a disease of the heart muscle, of slow progression that courseswith an eccentric dilation of the ventricular walls with decrease of the myocardium contractility, leading to asystolic dysfunction. After this the atrials cameras expand, causing poor diastolic function producing finallycongestive heart insufficiency and failure. It is the most common disturbance of the canine myocardium. It occursin young dogs or of stocking age and the exact etiology is unknown, although genetic and nutritive factors havebeen appointed. The disease seems to happen more commonly in pure dogs and in families groups suggesting ahereditary component. Blocking beta Carvedilol is well tolerated by human patients with congestive heartinsufficiency. Carvedilol blocks by competition the receptors beta1, beta2 and alpha1, the drug lacks ofsympathomimetic activity and produce vasodilatation mainly through the blockade alpha 1. It is assumed by theuse of carvedilol an improvement of the myocardic function due to a reduction in the left ventricular size withregression of the hypertrophy in human patients with light and moderate essential hypertension. It wasdemonstrated in humans, protecting effects against the myocardic necrosis, arrythmia and against the cellularoffense caused by free radicals. With intention of testing the use of Carvedilol for the treatment of dilatedcardiomyopathy in dogs, a clinical study was accomplished in 7 dogs, treated with 3,125 mg/animal of carvedilol.The heart monitoring was fundamentally conducted by the analysis of the heart silhouette starting from x-rays insequence, analyzed through the program AUTOCAD 2002 . Considering the results of decrease of the heart area, clinical improvement, longevity with quality obtained with the use of the drug, it is suggested theaccomplishment of multicentric studies in dogs with dilated cardiomyopathy. The survey of the cardiac area withthe use of AUTOCAD 2002 , should be introduced in clinical veterinary practice for its versatility, low cost andeffectiveness, providing trust worthy parameters of the evolution for long periods of dilated cardiomyopathy indogs.ACardiomiopatia Dilatada Canina é uma doença do músculo cardíaco, de progressão lenta, na qualocorre inicialmente uma dilatação excêntrica das paredes ventriculares com diminuição da contratilidademiocárdica, o que leva a uma disfunção sistólica e a um quadro final de insuficiência cardíaca congestiva. É odistúrbio mais comum do miocárdio canino, predominando em cães jovens ou de meia idade, de médio ougrande porte, e embora sua etiologia exata seja desconhecida, fatores genéticos e nutricionais têm sidoapontados. O carvedilol é um bloqueador competitivo dos receptores 1 e 2, não possuindo atividadesimpatomimética e possuindo propriedade vasodilatadora exercida principalmente por meio do bloqueio 1.Aocarvedilol tem sido atribuída a melhora da função miocárdica, particularmente na fase de pós-carga, bem comoa redução do volume ventricular esquerdo, mediante regressão da hipertrofia ventricular, em pacientes comhipertensão essencial leve e moderada. Em humanos, efeitos cardioprotetores contra necrose miocárdica,arritmia e injúria celular causada por radicais livres tem sido demonstrados. Com intuito de avaliar o uso docarvedilol no remodelamento cardíaco à miocardiopatia dilatada em cães, foi realizado um estudo clínico emsete animais, submetidos a protocolo de monoterapia com carvedilol, na dose de 3,125 mg/animal. Omonitoramento cardíaco deu-se fundamentalmente, pela análise da silhueta cardíaca a partir de radiografiasseqüenciais analisadas pelo programa de informática AUTOCAD 2002 . Considerando os resultados dediminuição da área cardíaca e melhora clínica sugere-se a realização de estudo multicêntrico em cãesportadores de cardiomiopatia dilatada.Ainterpretação da área de remodelamento cardíaco com a utilização doAUTOCAD 2002 pode ser adotada como prática no acompanhamento de pacientes com cardiomiopatiadilatada por longos períodos pela sua versatilidade, baixo custo e por proporcionar mais um parâmetro naavaliação da evolução desta cardiopatia

Determinação de grupos de maturação em soja para o Brasil.

bitstream/item/134202/1/ID13022-1980-1981sojaresultados-p50-57.pdfTrabalho apresentado na IX Reunião de Pesquisa de Soja da Região Sul, Passo Fundo, 1981

Isotope shift calculations for atoms with one valence electron

This work presents a method for the ab initio calculation of isotope shift in atoms and ions with one valence electron above closed shells. As a zero approximation we use relativistic Hartree-Fock and then calculate correlation corrections. The main motivation for developing the method comes from the need to analyse whether different isotope abundances in early universe can contribute to the observed anomalies in quasar absorption spectra. The current best explanation for these anomalies is the assumption that the fine structure constant, alpha, was smaller at early epoch. We test the isotope shift method by comparing the calculated and experimental isotope shift for the alkali and alkali-like atoms Na, MgII, K, CaII and BaII. The agreement is found to be good. We then calculate the isotope shift for some astronomically relevant transitions in SiII and SiIV, MgII, ZnII and GeII.Comment: 11 page

Ocorrência de fungos em sementes de sorgo, milho, soja e trigo.

bitstream/item/31577/1/comunicado76.pd