Detection of renal dysfunction during and after anaesthesia and surgery - evaluation of the influence of inorganic fluoride, ketorolac and clonidine

Drugs and surgical techniques may have harmful renal effects during the perioperative period. Traditional biomarkers are often insensitive to minor renal changes, but novel biomarkers may more accurately detect disturbances in glomerular and tubular function and integrity. The purpose of this study was first, to evaluate the renal effects of ketorolac and clonidine during inhalation anesthesia with sevoflurane and isoflurane, and secondly, to evaluate the effect of tobacco smoking on the production of inorganic fluoride (F-) following enflurane and sevoflurane anesthesia as well as to determine the effect of F- on renal function and cellular integrity in surgical patients. A total of 143 patients undergoing either conventional (n = 75) or endoscopic (n = 68) inpatient surgery were enrolled in four studies. The ketorolac and clonidine studies were prospective, randomized, placebo controlled and double-blinded, while the cigarette smoking studies were prospective cohort studies with two parallel groups. As a sign of proximal tubular deterioration, a similar transient increase in urine N-acetyl-beta-D-glucosaminidase/creatinine (U-NAG/crea) was noted in both the ketorolac group and in the controls (baseline vs. at two hours of anesthesia, p = 0.015) with a 3.3 minimum alveolar concentration hour sevoflurane anesthesia. Uncorrelated U-NAG increased above the maximum concentration measured from healthy volunteers (6.1 units/l) in 5/15 patients with ketorolac and in none of the controls (p = 0.042). As a sign of proximal tubular deterioration, U-glutathione transferase-alpha/crea (U-GST-alpha/crea) increased in both groups at two hours after anesthesia but a more significant increase was noted in the patients with ketorolac. U-GST-alpha/crea increased above the maximum ratio measured from healthy volunteers in 7/15 patients with ketorolac and in 3/15 controls. Clonidine diminished the activation of the renin-angiotensin aldosterone system during pneumoperitoneum; urine output was better preserved in the patients treated with clonidine (1/15 patients developed oliguria) than in the controls (8/15 developed oliguria (p=0.005)). Most patients with pneumoperitoneum and isoflurane anesthesia developed a transient proximal tubular deterioration, as U-NAG increased above 6.1 units/L in 11/15 patients with clonidine and in 7/15 controls. In the patients receiving clonidine treatment, the median of U-NAG/crea was higher than in the controls at 60 minutes of pneumoperitoneum (p = 0.01), suggesting that clonidine seems to worsen proximal tubular deterioration. Smoking induced the metabolism of enflurane, but the renal function remained intact in both the smokers and the non-smokers with enflurane anesthesia. On the contrary, smoking did not induce sevoflurane metabolism, but glomerular function decreased in 4/25 non-smokers and in 7/25 smokers with sevoflurane anesthesia. All five patients with S-F- ≥ 40 micromol/L, but only 6/45 with S-F- less than 40 micromol/L (p = 0.001), developed a S-tumor associated trypsin inhibitor concentration above 3 nmol/L as a sign of glomerular dysfunction. As a sign of proximal tubulus deterioration, U-beta 2-microglobulin increased in 2/5 patients with S-F- over 40 micromol/L compared to 2/45 patients with the highest S-F- less than 40 micromol/L (p = 0.005). To conclude, sevoflurane anesthesia may cause a transient proximal tubular deterioration which may be worsened by a co-administration of ketorolac. Clonidine premedication prevents the activation of the renin-angiotensin aldosterone system and preserves normal urine output, but may be harmful for proximal tubules during pneumoperitoneum. Smoking induces the metabolism of enflurane but not that of sevoflurane. Serum F- of 40 micromol/L or higher may induce glomerular dysfunction and proximal tubulus deterioration in patients with sevoflurane anesthesia. The novel renal biomarkers warrant further studies in order to establish reference values for surgical patients having inhalation anesthesia.

Synthesis and Characterization of a Class of Donor-Acceptor Conjugated Molecules: Experiments and Theoretical Calculations

A class of conjugated molecules containing donor (thiophene) and acceptor (malononitrile) is synthesized by Knoevenagel condensation reaction between 2-(2,6-dimethy1-4H-pyran-4-ylidene) malononitrile and thiophene carbaldehyde containing two and three thiophene units. The resulting molecules are characterized by H-1 and C-13 NMR. We have performed UV-vis absorption, fluorescence, and cyclic voltammetry measurements on these materials. The spectroscopic and electrochemical measurements proved beyond doubt that these materials possess lowexcitation gap and are suitable for being an active material in various electronic devices. We have also performed electronic structure calculations using density functional theory (DFT) and INDO/SCI methods to characterize the ground and excited states of this class of molecules. These donor-acceptor molecules show a strong charge transfercharacter that increases with the increase in the number of thiophene rings coupled to the malononitrile acceptor moiety. We have also calculated the pi-coherence length, Stoke's shift, and effect of solvents on excited states for this class of molecules, Our theoretical values agree well with experimental results.

Analysis of continuous beams—a three dimensional elasticity solution

A three dimensional elasticity solution for the analysis of beams continuous over an infinite number of equally spaced supports has been given. The beam has been subjected to normal tractions on its two opposite faces and these loads are identical over each span. The other two faces are traction free. Numerical results have been given for different cases when the beam is loaded on its bottom face. The results obtained have been compared with the results of two dimensional elasticity solution.

Determination of the orthotropic plate parameters of stiffened plates and grillages in free vibration

It is well known that the analysis of vibration of orthogonally stiffened rectangular plates and grillages may be simplified by replacing the actual structure by an orthotropic plate. This needs a suitable determination of the four elastic rigidity constants Dx, Dy, Dxy, D1 and the mass {Mathematical expression} of the orthotropic plate. A method is developed here for determining these parameters in terms of the sectional properties of the original plate-stiffener combination or the system of interconnected beams. Results of experimental work conducted on aluminium plates agree well with the results of the theory developed here.

Large deflections of rectangular plates

Approximate solutions for the non-linear bending of thin rectangular plates are presented considering large deflections for various boundary conditions. In the case of stress-free edges, solutions are given for von Kármán's equations in terms of the stress function and the deflection of the plate. In the case of immovable edges, equations are constructed in terms of the three displacements and these are solved. The solution is given by using double series consisting of the appropriate Beam Functions which satisfy the boundary conditions. The differential equations are satisfied by using the orthogonality properties of the series. Numerical results for square plates with uniform lateral load indicate good convergence of the series solution presented here.

Elastic stress analysis of jointed half-planes

Using a Fourier-integral approach, the problem of stress analysis in a composite plane consisting of two half-planes of different elastic properties rigidly joined along their boundaries has been solved. The analysis is done for a force acting in one of the half-planes for both cases when the force acts parallel and perpendicular to the interface. As a particular case, the interface stresses are evaluated when the interface is smooth. Some properties of the normal stress at the interface are discussed both for plane stress and plane strain conditions.

Vibration of rectangular orthotropic plates

An approximate analytical procedure has been given to solve the problem of a vibrating rectangular orthotropic plate, with various combinations of simply supported and clamped boundary conditions. Numerical results have been given for the case of a clamped square plate. Nomenclature 2a, 2b sides of the rectangular plate h plate thickness Eprime x , Eprime y , EPrime, G elastic constants of te orthotropic material D x Eprime x h 3/12 D y Eprime y h 3/12 H xy EPrimeh 3/12+Gh 3/6 D x , D y and H xy are rigidity constants of the orthotropic platergr mass of the plate per unit area ngr Poisson's ratio W deflection of the plate p circular frequency gamma b/a ratio X m , Y characteristic functions of the vibrating beam problem -lambda rgrp 2 a 2 b 2/H xy the frequency parameter.

On the theory of the indentation test for the measurement of tensile strength of brittle materials

A theoretical solution has been obtained for the state of stress in a rectangular plate under a pair of symmetrically placed rigid indenters. The stress distributions along the two central axes have been calculated for a square plate assuming the pressure distribution under the indenters as uniform, parabolic and one resulting from 'constant displacement' on a semiinfinite boundary, for different ratios of indenter-width to side of square. The results are compared with those of photoelastic analysis of Berenbaum and Brodie and the validity of the solution is discussed. The solution has been extended to orthotropic materials and numerical results for one type of coal are given.

Growth of ionization currents in dry air at high values of E/N

Uniform field steady-state ionization currents were measured in dry air as a function of N at constant E/N (E is the electric field strength and N the gas number density) and constant electrode separation d for 14·13 × 10-16 less-than-or-eq, slant E/N less-than-or-eq, slant 282·5 × 10-16 V cm2. Uniform field sparking potentials were also measured for Nd range 1·24 × 1016 less-than-or-eq, slant Nd less-than-or-eq, slant 245 × 1016 cm-2. The ratio of the Townsend primary ionization coefficient α to N, α/N, was found to depend on E/N only. The secondary coefficients were also evaluated for aluminium and gold-plated electrodes for the above range of E/N. Measurements of the sparking potentials showed that Paschen's law is not obeyed in air at values of Nd near and below the Paschen minimum.

Role of the leaving group in the base-catalysed hydrolysis of pseudo-esters

The relative insensitivity of the rate of hydrolysis of γ-pseudo-esters to the leaving group compared to that of the normal esters emphasises that the conjugative ability is an important factor in determining the rate of hydrolysis of esters

The ratio of diffusion coefficient to mobility for slow electrons in dry air

Using Huxley's solution of the diffusion equation for electron-attaching gases, the ratio of diffusion coefficient D to mobility μ for electrons in dry air was measured over the range 3·06 × 10-17 of earlier workers who used the diffusion equation for non-attaching gases.

Comparison of elasticity and shell-theory solutions for finite circular cylindrical shells

A finite circular cylindrical shell subjected to a band of uniform pressure on its outer rim was investigated, using three-dimensional elasticity theory and the classical shell theories of Timoshenko (or Donnell) and Flügge. Detailed comparison of the resulting stresses and displacements was carried out for shells with ratios of inner to outer shell radii equal to 0.80, 0.85, 0.90 and 0.93 and for ratios of outer shell diameter to length of the shell equal to 0.5, 1 and 2. The ratio of band width to length of the shell was 0.2 and Poisson's ratio used was equal to 0.3. An Elliot 803 digital computer was used for numerical computations.

Numerical simulations of crack tip fields in polycrystalline plastic solids

In this paper, modes I and II crack tip fields in polycrystalline plastic solids are studied under plane strain, small scale yielding conditions. Two different initial textures of an Al–Mg alloy, viz., continuous cast AA5754 sheets in the recrystallized and cold rolled conditions, are considered. The former is nearly-isotropic, while the latter displays distinct anisotropy. Finite element simulations are performed by employing crystal plasticity constitutive equations along with a Taylor-type homogenization as well as by using the Hill quadratic yield theory. It is found that significant texture evolution occurs close to the notch tip which profoundly influences the stress and plastic strain distributions. Also, the cold rolling texture gives rise to higher magnitude of plastic strain near the tip.