Measuring Cardiac Output in the Critically Ill

__Abstract__ Haemodynamic monitoring plays an essential part on the care of the critically ill patient. Monitoring has two goals; the first goal is a signalling function if the patients clinical condition improves or deteriorates adequate measures can be taken. Maintaining the adequacy of the circulation reduces the chance of inadequate oxygen transport to the tissues preventing organ ischemia. The second goal is using the monitoring as a decision making tool. Historically, arterial pressures were measured because they were easier to measure than bloodflow. But the introduction of the pulmonary artery catheter (PAC) in 1970 allowed the regular measurement of cardiac output (CO) at the beside. Beside CO a new array of variables could be monitored. Measuring more variables did not automatically relate to better outcomes

Эффективность производства в крестьянских (фермерских) хозяйствах Крыма

Автор статьи исследует динамику развития крестьянских (фермерских) хозяйств в Крыму в период 1991 по 2004 года. Дается сравнительный анализ эффективности производства в крестьянских (фермерских) хозяйствах и сельскохозяйственных предприятиях. В работе значительное внимание уделено вкладу крестьянских (фермерских) хозяйств в развитии АПК Крыма

Urological Complications in Kidney Transplantation

__Abstract__ The kidney is an essential organ that plays an crucial role in acid-base balance, sodium and potassium balance, calcium metabolism, regulation of blood pressure, red blood cell synthesis and excretion of metabolites. Kidney diseases may result in kidney failure with the requirement of kidney replacement therapy like dialysis. Hemodialysis and peritoneal dialysis may extend patient survival but does not cure the kidney failure. Kidney transplantation is considered the optimal kidney replacement therapy for patients with end stage kidney failure, resulting in decreased morbidity, improved quality of life and higher costs effectiveness when compared to dialysis. In the early years of experimental kidney transplantation, donor kidneys were placed in the thigh with cutaneous ureterostomy drainage or in the iliac fossa with drainage by ureteroureterostomy to the recipient native ureter. In January 1951, Rene Kuss placed a donor kidney into the iliopelvic region of the recipient with cutaneous ureterostomy.1, 2 Soon thereafter another French surgical team established the concept that a kidney place

Para-Functionalized NCN-Pincer Palladium and Platinum Complexes as Building Blocks in Organometallic Chemistry

A rapidly evolving field in chemistry is the application of organometallic and coordination complexes as building blocks or active components for the construction of new materials exhibiting specific catalytic, redox, optical or sensor activities. A central theme in the construction of these inorganic building blocks is the targeted functionalization of ligands, either prior to or, less conventionally, after the metallation step. Ligand functionalization enables the immobilization of the transition-metal complexes on macromolecular or inorganic supports, the regulation of their solubility, the introduction of additional functional moieties, as well as the electronic tuning of the metal. Furthermore, the functionalized complexes can be applied in inorganic crystal engineering or for targeted (supramolecular) assembly in solution. The NCN-pincer ligand (NCN = 2,6-bis[(dimethylamino)methyl]-phenyl anion) is a versatile building block for these purposes. NCN-pincer palladium(II) and platinum(II) complexes (Chart 1) are air- and water-stable, and find widespread applications in the field of catalysis and as sensor materials. Para-functionalization of these complexes offers an anchoring point, while leaving the structural integrity of the metal center intact. X M=Pd(II), Pt(II) ! X= counter ion and/or Me2N---M---Nme2 coordinating ligand ?? Z= functionalization site Z Chart 1 The results described in this thesis show that NCN-pincer palladium and platinum complexes are versatile building blocks for the construction of new organometallic materials with applications in diverse fields such as catalysis, crystal engineering, and (macro)molecular visualization. The pathways presented for the synthesis of the new para-functionalized NCN-pincer complexes are of crucial importance for generating a suitable anchoring point for further functionalizations without affecting the M C bond. Important aspects concerning their synthesis include: i) the exceptional stability of the NCN-complexes, allowing ligand modifications after the metallation step, and ii) the availability of various metallation procedures for selective introduction of the palladium or platinum center in the NCN-ligand. Both features offer a high degree of flexibility in the synthesis of the para-functionalized complexes, making functionalization with virtually any (organic) group feasible. Noteworthy are the linear Hammett correlations found for the para-substituted NCN-platinum complexes. Extension of these correlations to NCN-pincer complexes of other metals, and eventually to PCP- or SCS-pincer complexes, allows subtle tuning of the electron density on their metal centers, and consequently theoretical predictions of their catalytic and/or optical properties. The application of NCN-pincer building blocks in the examples shown in this thesis illustrate the above-mentioned features, i.e. selective metallation of the ligand at various stages of the syntheses and modifications on the ligand after the metallation step. The methodology employed in the preparation of the pincer complexes can be used as a starting point for the construction of new organometallic materials based on the pincer ligand. These materials can be designed to exhibit bio- or solvent-compatibility and/or specific aggregation behavior. Finally, (non)-covalent assembly of catalytically active NCN-pincer complexes with other functional moieties, e.g. (co)catalysts or receptor sites, offers the opportunity to construct bifunctional or supramolecular catalysts

Practical Aspects of Carbon-Carbon Cross-Coupling Reactions Using Heteroarenes

The use of cross-coupling reactions for the preparation of alkylated and arylated heteroaromatic compounds has increased tremendously over the past two decades. This has been driven on the one hand by the increasingly complex structures of new drugs, most of which contain one or more heterocyclic motifs. On the other hand, the development of new catalysts and reaction conditions for these reactions has rendered even the most unreactive of heteroarenes amenable to cross-coupling chemistry. Not only have new bulky electron-donating ligands been created that allow the coupling of aryl chlorides under mild conditions, but also the use of ligand-free palladium, in particular at very low doses, sometimes called homeopathic palladium, has served to bring down the cost of these reactions. More recent and enabling developments are the use of catalysts based on cheap metals such as nickel, copper, and iron. Scale-up issues are availability and cost of starting materials, cost of the catalysts (related to cost of the metal and the ligand, intrinsic activity and stability of the catalyst), solvent choice, and removal of the metal t