Difuzní parametry extracelulárního prostoru a metabolismus somatosensorického kortexu krys během rekonvalescence z tranzientní globální ischemie a hypoxie

Difuzní parametry extracelulárního prostoru a metabolismus somatosensorického kortexu krys během rekonvalescence z tranzientní globální ischemie a hypoxie Powered by TCPDF (www.tcpdf.org)Content Abstract .................................................................. ..... ...... ............................ .... 2 Introduction ............................................ ........................................ .................. 4 Aims .................. ................. ................................ ....... ..... . ............ .......... 6 Methods ............................................... ......................................................... ... 7 Results ................ ............................................................................ .................. 9 Discussion .. ... ............... .. ......... .. .......................... ............................. ... ............. 13 References ....... ................................................................ ....................... ........ 20 List of Publications ............. .... .. ............... .. ... .. .......... .. ... ............................... .... 22 Abstract The extracellular space (ECS) of the brain represents the microenvironment of nerve cells and enables the diffusion of neuroactive substances among neurons, axons and glia. Changes in the ECS diffusion parameters during ischemia are well known, but information about changes in ECS diffusion and energy-related metabolite...Units out of CUMimofakultní pracoviště2. lékařská fakultaSecond Faculty of Medicin

Short-term elevation of intracranial pressure does neither influence duodenal motility nor frequency of bolus transport events: a porcine model

BACKGROUND: Patients with traumatic brain injuries and raised intracranial pressure (ICP) display biphasic response with faster gastric emptying during the early stage followed by a prolonged gastric transit time later. While duodenal contractile activity plays a pivotal role in transpyloric transit we investigated the effects of raised intracranial pressure on duodenal motility during the early phase. In order to exclude significant deterioration of mucosal blood supply which might also influence duodenal motility, luminal microdialysis was used in conjunction. METHODS: During general anaesthesia, 11 pigs (32–37 kg, German Landrace) were instrumented with both a luminal catheter for impedancometry and a luminal catheter for microdialysis into the proximal duodenum. Additionally, a catheter was inserted into the left ventricle to increase the intracranial pressure from baseline up to 50 mmHg in steps of 10 mmHg each hour by injection of artificial cerebrospinal fluid. At the same time, duodenal motility was recorded continuously. Duodenal luminal lactate, pyruvate, and glucose concentrations were measured during physiological state and during elevated intracranial pressure of 10, 20, 30, 40, and 50 mmHg in six pigs. Five pigs served as controls. RESULTS: Although there was a trend towards shortened migrating motor cycle (MMC) length in pigs with raised ICP, the interdigestive phase I–III and the MMC cycle length were comparable in the groups. Spontaneous MMC cycles were not disrupted during intracranial hypertension. The mean concentration of lactate and glucose was comparable in the groups, while the concentration of pyruvate was partially higher in the study group than in the controls (p < 0.05). This was associated with a decrease in lactate to pyruvate ratio (p < 0.05). CONCLUSION: The present study suggests that a stepwise and hourly increase of the intracranial pressure of up to 50 mmHg, does not influence duodenal motility activity in a significant manner. A considerable deterioration of the duodenal mucosal blood flow was excluded by determining the lactate to pyruvate ratio

Diel changes in bulk and single-cell bacterial heterotrophic activity in winter surface waters of the northwestern Mediterranean Sea

14 pages, 8 figures, 2 tablesTwo diel cycle studies were conducted to determine the effect of day–night light changes on winter bacterial activity in the coastal Mediterranean (Blanes Bay Microbial Observatory). Bacterial abundances, bacterial heterotrophic activity, and flagellate grazing counts were determined at 4-h intervals during two 3-d periods separated by 2 d. Twice a day, the single-cell activity of major bacterial groups was further analyzed by applying microautoradiography combined with catalyzed reporter deposition-fluorescence in situ hybridization. During the first cycle, all the measured parameters (including the number of active cells in most groups) varied synchronously, with higher values at night and lower during the day. An episode of strong winds between the two studied periods disrupted this periodicity at the onset of the second cycle. The bulk incorporation of 3H-leucine recovered the diel pattern after 2 d, mostly driven by the activity of Gammaproteobacteria. Among the possibilities considered, the observed nighttime increases in the grazing activity of heterotrophic nanoflagellates appeared to partially drive the activity of all bacterial taxa through potential periodic release of dissolved organic matterThis work has been supported by the Spanish Ministry of Science and Innovation (MICINN)through the projects ‘‘Fuentes de Materia Orgánica, Diversidad microbiana y funcionamiento (respiración y Uso del carbono) del ecosistema marino pelágico costero’’ (MODIVUS) (Ciencias y Tecnologías Marinas-CTM2005-04795/MAR) and ‘‘Surface Mixing Modulation of the Exposure to solar Radiation’’ (SUMMER) (Ciencias y Tecnologías Marinas-CTM2008-03309/MAR)Peer reviewe

Does a 4 diagram manual enable laypersons to operate the laryngeal mask supreme®? A pilot study in the manikin

<p>Abstract</p> <p>Background</p> <p>Bystander resuscitation plays an important role in lifesaving cardiopulmonary resuscitation (CPR). A significant reduction in the "no-flow-time", quantitatively better chest compressions and an improved quality of ventilation can be demonstrated during CPR using supraglottic airway devices (SADs). Previous studies have demonstrated the ability of inexperienced persons to operate SADs after brief instruction. The aim of this pilot study was to determine whether an instruction manual consisting of four diagrams enables laypersons to operate a Laryngeal Mask Supreme^®(LMAS) in the manikin.</p> <p>Methods</p> <p>An instruction manual of four illustrations with speech bubbles displaying the correct use of the LMAS was designed. Laypersons were handed a bag containing a LMAS, a bag mask valve device (BMV), a syringe prefilled with air and the instruction sheet, and were asked to perform and ventilate the manikin as displayed. Time to ventilation was recorded and degree of success evaluated.</p> <p>Results</p> <p>A total of 150 laypersons took part. Overall 145 participants (96.7%) inserted the LMAS in the manikin in the right direction. The device was inserted inverted or twisted in 13 (8.7%) attempts. Eight (5.3%) individuals recognized this and corrected the position. Within the first 2 minutes 119 (79.3%) applicants were able to insert the LMAS and provide tidal volumes greater than 150 ml (estimated dead space). Time to insertion and first ventilation was 83.2 ± 29 s. No significant difference related to previous BLS training (P = 0.85), technical education (P = 0.07) or gender could be demonstrated (P = 0.25).</p> <p>Conclusion</p> <p>In manikin laypersons could insert LMAS in the correct direction after onsite instruction by a simple manual with a high success rate. This indicates some basic procedural understanding and intellectual transfer in principle. Operating errors (n = 91) were frequently not recognized and corrected (n = 77). Improvements in labeling and the quality of instructional photographs may reduce individual error and may optimize understanding.</p

Short term non-invasive ventilation post-surgery improves arterial blood-gases in obese subjects compared to supplemental oxygen delivery - a randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>In the immediate postoperative period, obese patients are more likely to exhibit hypoxaemia due to atelectasis and impaired respiratory mechanics, changes which can be attenuated by non-invasive ventilation (NIV). The aim of the study was to evaluate the duration of any effects of early initiation of short term pressure support NIV vs. traditional oxygen delivery via venturi mask in obese patients during their stay in the PACU.</p> <p>Methods</p> <p>After ethics committee approval and informed consent, we prospectively studied 60 obese patients (BMI 30-45) undergoing minor peripheral surgery. Half were randomly assigned to receive short term NIV during their PACU stay, while the others received routine treatment (supplemental oxygen via venturi mask). Premedication, general anaesthesia and respiratory settings were standardized. We measured arterial oxygen saturation by pulse oximetry and blood gas analysis on air breathing. Inspiratory and expiratory lung function was measured preoperatively (baseline) and at 10 min, 1 h, 2 h, 6 h and 24 h after extubation, with the patient supine, in a 30 degrees head-up position. The two groups were compared using repeated-measure analysis of variance (ANOVA) and t-test analysis. Statistical significance was considered to be P < 0.05.</p> <p>Results</p> <p>There were no differences at the first assessment. During the PACU stay, pulmonary function in the NIV group was significantly better than in the controls (p < 0.0001). Blood gases and the alveolar to arterial oxygen partial pressure difference were also better (p < 0.03), but with the addition that overall improvements are of questionable clinical relevance. These effects persisted for at least 24 hours after surgery (p < 0.05).</p> <p>Conclusion</p> <p>Early initiation of short term NIV during in the PACU promotes more rapid recovery of postoperative lung function and oxygenation in the obese. The effect lasted 24 hours after discontinuation of NIV. Patient selection is necessary in order to establish clinically relevant improvements.</p> <p>Trial Registration#</p> <p>DRKS00000751; <url>http://www.germanctr.de</url></p

Use of gaming and simulation‐design technology in the formation of the readiness would‐be teachers of geography for specialized education of senior pupils

 В статті здійснено аналіз використання імітаційноігрових і проектних технологій у процесі професійнопедагогічної підготовки майбутніх учителів географії. Виявлено можливості та з’ясовано вплив означених технологій на процес формування готовності майбутніх учителів географії до профільного навчання старшокласників

The use of the Airtraq® optical laryngoscope for routine tracheal intubation in high-risk cardio-surgical patients

<p>Abstract</p> <p>Background</p> <p>The Airtraq^®optical laryngoscope (Prodol Ltd., Vizcaya, Spain) is a novel disposable device facilitating tracheal intubation in routine and difficult airway patients. No data investigating routine tracheal intubation using the Airtaq^®in patients at a high cardiac risk are available at present. Purpose of this study was to investigate the feasibility and hemodynamic implications of tracheal intubation with the Aitraq^®optical laryngoscope, in high-risk cardio-surgical patients.</p> <p>Methods</p> <p>123 consecutive ASA III patients undergoing elective coronary artery bypass grafting were routinely intubated with the Airtraq^®laryngoscope. Induction of anesthesia was standardized according to our institutional protocol. All tracheal intubations were performed by six anesthetists trained in the use of the Airtraq^®prior.</p> <p>Results</p> <p>Overall success rate was 100% (n = 123). All but five patients trachea could be intubated in the first attempt (95,9%). 5 patients were intubated in a 2nd (n = 4) or 3rd (n = 1) attempt. Mean intubation time was 24.3 s (range 16-128 s). Heart rate, arterial blood pressure and SpO₂were not significantly altered. Minor complications were observed in 6 patients (4,8%), i.e. two lesions of the lips and four minor superficial mucosal bleedings. Intubation duration (p = 0.62) and number of attempts (p = 0.26) were independent from BMI and Mallampati score.</p> <p>Conclusion</p> <p>Tracheal intubation with the Airtraq^®optical laryngoscope was feasible, save and easy to perform in high-risk patients undergoing cardiac surgery. In all patients, a sufficient view on the vocal cords could be obtained, independent from BMI and preoperative Mallampati score.</p> <p>Trial Registration</p> <p>DRKS 00003230</p

Extracellular space diffusion parameters and metabolism in the rat somatosrensory cortex during recovery from trabsient global ischemia and hypoxia

Content Abstract .................................................................. ..... ...... ............................ .... 2 Introduction ............................................ ........................................ .................. 4 Aims .................. ................. ................................ ....... ..... . ............ .......... 6 Methods ............................................... ......................................................... ... 7 Results ................ ............................................................................ .................. 9 Discussion .. ... ............... .. ......... .. .......................... ............................. ... ............. 13 References ....... ................................................................ ....................... ........ 20 List of Publications ............. .... .. ............... .. ... .. .......... .. ... ............................... .... 22 Abstract The extracellular space (ECS) of the brain represents the microenvironment of nerve cells and enables the diffusion of neuroactive substances among neurons, axons and glia. Changes in the ECS diffusion parameters during ischemia are well known, but information about changes in ECS diffusion and energy-related metabolite..