984 resultados para Continuous monitoring with Polarographic Oxygen Sensor
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Máster Universitario en Sistemas Inteligentes y Aplicaciones Numéricas en Ingeniería (SIANI)
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Máster Universitario en Sistemas Inteligentes y Aplicaciones Numéricas en Ingeniería (SIANI)
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This work is structured as follows: In Section 1 we discuss the clinical problem of heart failure. In particular, we present the phenomenon known as ventricular mechanical dyssynchrony: its impact on cardiac function, the therapy for its treatment and the methods for its quantification. Specifically, we describe the conductance catheter and its use for the measurement of dyssynchrony. At the end of the Section 1, we propose a new set of indexes to quantify the dyssynchrony that are studied and validated thereafter. In Section 2 we describe the studies carried out in this work: we report the experimental protocols, we present and discuss the results obtained. Finally, we report the overall conclusions drawn from this work and we try to envisage future works and possible clinical applications of our results. Ancillary studies that were carried out during this work mainly to investigate several aspects of cardiac resynchronization therapy (CRT) are mentioned in Appendix. -------- Ventricular mechanical dyssynchrony plays a regulating role already in normal physiology but is especially important in pathological conditions, such as hypertrophy, ischemia, infarction, or heart failure (Chapter 1,2.). Several prospective randomized controlled trials supported the clinical efficacy and safety of cardiac resynchronization therapy (CRT) in patients with moderate or severe heart failure and ventricular dyssynchrony. CRT resynchronizes ventricular contraction by simultaneous pacing of both left and right ventricle (biventricular pacing) (Chapter 1.). Currently, the conductance catheter method has been used extensively to assess global systolic and diastolic ventricular function and, more recently, the ability of this instrument to pick-up multiple segmental volume signals has been used to quantify mechanical ventricular dyssynchrony. Specifically, novel indexes based on volume signals acquired with the conductance catheter were introduced to quantify dyssynchrony (Chapter 3,4.). Present work was aimed to describe the characteristics of the conductancevolume signals, to investigate the performance of the indexes of ventricular dyssynchrony described in literature and to introduce and validate improved dyssynchrony indexes. Morevoer, using the conductance catheter method and the new indexes, the clinical problem of the ventricular pacing site optimization was addressed and the measurement protocol to adopt for hemodynamic tests on cardiac pacing was investigated. In accordance to the aims of the work, in addition to the classical time-domain parameters, a new set of indexes has been extracted, based on coherent averaging procedure and on spectral and cross-spectral analysis (Chapter 4.). Our analyses were carried out on patients with indications for electrophysiologic study or device implantation (Chapter 5.). For the first time, besides patients with heart failure, indexes of mechanical dyssynchrony based on conductance catheter were extracted and studied in a population of patients with preserved ventricular function, providing information on the normal range of such a kind of values. By performing a frequency domain analysis and by applying an optimized coherent averaging procedure (Chapter 6.a.), we were able to describe some characteristics of the conductance-volume signals (Chapter 6.b.). We unmasked the presence of considerable beat-to-beat variations in dyssynchrony that seemed more frequent in patients with ventricular dysfunction and to play a role in discriminating patients. These non-recurrent mechanical ventricular non-uniformities are probably the expression of the substantial beat-to-beat hemodynamic variations, often associated with heart failure and due to cardiopulmonary interaction and conduction disturbances. We investigated how the coherent averaging procedure may affect or refine the conductance based indexes; in addition, we proposed and tested a new set of indexes which quantify the non-periodic components of the volume signals. Using the new set of indexes we studied the acute effects of the CRT and the right ventricular pacing, in patients with heart failure and patients with preserved ventricular function. In the overall population we observed a correlation between the hemodynamic changes induced by the pacing and the indexes of dyssynchrony, and this may have practical implications for hemodynamic-guided device implantation. The optimal ventricular pacing site for patients with conventional indications for pacing remains controversial. The majority of them do not meet current clinical indications for CRT pacing. Thus, we carried out an analysis to compare the impact of several ventricular pacing sites on global and regional ventricular function and dyssynchrony (Chapter 6.c.). We observed that right ventricular pacing worsens cardiac function in patients with and without ventricular dysfunction unless the pacing site is optimized. CRT preserves left ventricular function in patients with normal ejection fraction and improves function in patients with poor ejection fraction despite no clinical indication for CRT. Moreover, the analysis of the results obtained using new indexes of regional dyssynchrony, suggests that pacing site may influence overall global ventricular function depending on its relative effects on regional function and synchrony. Another clinical problem that has been investigated in this work is the optimal right ventricular lead location for CRT (Chapter 6.d.). Similarly to the previous analysis, using novel parameters describing local synchrony and efficiency, we tested the hypothesis and we demonstrated that biventricular pacing with alternative right ventricular pacing sites produces acute improvement of ventricular systolic function and improves mechanical synchrony when compared to standard right ventricular pacing. Although no specific right ventricular location was shown to be superior during CRT, the right ventricular pacing site that produced the optimal acute hemodynamic response varied between patients. Acute hemodynamic effects of cardiac pacing are conventionally evaluated after stabilization episodes. The applied duration of stabilization periods in most cardiac pacing studies varied considerably. With an ad hoc protocol (Chapter 6.e.) and indexes of mechanical dyssynchrony derived by conductance catheter we demonstrated that the usage of stabilization periods during evaluation of cardiac pacing may mask early changes in systolic and diastolic intra-ventricular dyssynchrony. In fact, at the onset of ventricular pacing, the main dyssynchrony and ventricular performance changes occur within a 10s time span, initiated by the changes in ventricular mechanical dyssynchrony induced by aberrant conduction and followed by a partial or even complete recovery. It was already demonstrated in normal animals that ventricular mechanical dyssynchrony may act as a physiologic modulator of cardiac performance together with heart rate, contractile state, preload and afterload. The present observation, which shows the compensatory mechanism of mechanical dyssynchrony, suggests that ventricular dyssynchrony may be regarded as an intrinsic cardiac property, with baseline dyssynchrony at increased level in heart failure patients. To make available an independent system for cardiac output estimation, in order to confirm the results obtained with conductance volume method, we developed and validated a novel technique to apply the Modelflow method (a method that derives an aortic flow waveform from arterial pressure by simulation of a non-linear three-element aortic input impedance model, Wesseling et al. 1993) to the left ventricular pressure signal, instead of the arterial pressure used in the classical approach (Chapter 7.). The results confirmed that in patients without valve abnormalities, undergoing conductance catheter evaluations, the continuous monitoring of cardiac output using the intra-ventricular pressure signal is reliable. Thus, cardiac output can be monitored quantitatively and continuously with a simple and low-cost method. During this work, additional studies were carried out to investigate several areas of uncertainty of CRT. The results of these studies are briefly presented in Appendix: the long-term survival in patients treated with CRT in clinical practice, the effects of CRT in patients with mild symptoms of heart failure and in very old patients, the limited thoracotomy as a second choice alternative to transvenous implant for CRT delivery, the evolution and prognostic significance of diastolic filling pattern in CRT, the selection of candidates to CRT with echocardiographic criteria and the prediction of response to the therapy.
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Im Rahmen meiner Dissertation untersuchte ich die intrazelluläre Lokalisation des Hämoglobin von Drosophila melanogaster, sowie von Neuroglobin und Cytoglobin der Vertebraten. Obwohl alle drei Globine erst kürzlich entdeckt wurden, liegen bereits Daten über ihre Struktur, ihre biochemischen Eigenschaften und die Lokalisation der mRNA vor. Ihre Funktionen konnten bisher jedoch nicht eindeutig geklärt werden. Das Globin von Drosophila melanogaster konnte mittels Westernblot sowohl in Larven als auch adulten Fliegen nachgewiesen werden. Ebenso war es mir möglich, mittels Immunperoxidaseuntersuchungen die Tracheen, die Terminalzellen der Tracheolen sowie die Fettkörperzellen als Ort der Globinexpression in Drosophila zu identifizieren. Diese Daten deuten darauf hin, dass dieses Globin eine Funktion als Sauerstoffpuffer, der sowohl Sauerstoff speichert als auch transportiert, hin. Damit würde das Drosophila Globin eine zu anderen Insektenglobinen vergleichbare Funktion übernehmen. Zum ersten Mal konnte gezeigt werden, dass Neuroglobin auch in der neuronalen Netzhaut von Säugern und Fischen vorkommt. Des Weiteren konnte Neuroglobin in der Retina zellulär sowie subzellulär lokalisiert werden. In der avaskulären Mäuseretina wurde Neuroglobin neben den Innensegmenten der Photorezeptorzellen, auch noch in den beiden plexiformen Schichten sowie in der Ganglienzellschicht gefunden. Die gezeigte Kolokalisation dieses intrazellulären Globins mit Mitochondrien und somit auch mit den Orten des höchsten Sauerstoffbedarfs in der Retina deutet auf eine Funktion im Sauerstofftransport zu den Mitochondrien hin. Des Weiteren könnte Neuroglobin auch als Sauerstoffspeicher dienen, der es Neuronen ermöglicht, kurzfristige hypoxische Bedingungen unbeschadet zu überstehen. Andere mögliche Funktionen wie z.B. die als Detoxifizierer von reaktiven Sauerstoff- bzw. Sickstoffverbindungen, als Sauerstoffsensor, sowie als terminale Oxidase erscheinen durch die gezeigten Daten eher unwahrscheinlich. Die bisherige Annahme, dass Cytoglobin ein ubiquitär exprimiertes Protein ist, konnte von mir nicht bestätigt werden. Für nichtneuronale Gewebe konnte gezeigt werden, dass Cytoglobin lediglich auf das Cytoplasma von Fibroblasten und ontogenetisch verwandte Zelltypen wie Osteoblasten, Chondroblasten und Sternzellen beschränkt ist. Möglicherweise hat Cytoglobin dort eine Funktion in der Kollagensynthese. Ferner wird Cygb cytoplasmatisch und nukleär in einigen Neuronen der Retina und des Gehirns exprimiert. Dort könnte Cygb z.B. nukleäre Enzyme wie die NO-Synthase mit Sauerstoff versorgen. Andere Funktionen scheinen aufgrund meiner Daten im Moment unwahrscheinlich.
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Für die Zukunft wird eine Zunahme an Verkehr prognostiziert, gleichzeitig herrscht ein Mangel an Raum und finanziellen Mitteln, um weitere Straßen zu bauen. Daher müssen die vorhandenen Kapazitäten durch eine bessere Verkehrssteuerung sinnvoller genutzt werden, z.B. durch Verkehrsleitsysteme. Dafür werden räumlich aufgelöste, d.h. den Verkehr in seiner flächenhaften Verteilung wiedergebende Daten benötigt, die jedoch fehlen. Bisher konnten Verkehrsdaten nur dort erhoben werden, wo sich örtlich feste Meßeinrichtungen befinden, jedoch können damit die fehlenden Daten nicht erhoben werden. Mit Fernerkundungssystemen ergibt sich die Möglichkeit, diese Daten flächendeckend mit einem Blick von oben zu erfassen. Nach jahrzehntelangen Erfahrungen mit Fernerkundungsmethoden zur Erfassung und Untersuchung der verschiedensten Phänomene auf der Erdoberfläche wird nun diese Methodik im Rahmen eines Pilotprojektes auf den Themenbereich Verkehr angewendet. Seit Ende der 1990er Jahre wurde mit flugzeuggetragenen optischen und Infrarot-Aufnahmesystemen Verkehr beobachtet. Doch bei schlechten Wetterbedingungen und insbesondere bei Bewölkung, sind keine brauchbaren Aufnahmen möglich. Mit einem abbildenden Radarverfahren werden Daten unabhängig von Wetter- und Tageslichtbedingungen oder Bewölkung erhoben. Im Rahmen dieser Arbeit wird untersucht, inwieweit mit Hilfe von flugzeuggetragenem synthetischem Apertur Radar (SAR) Verkehrsdaten aufgenommen, verarbeitet und sinnvoll angewendet werden können. Nicht nur wird die neue Technik der Along-Track Interferometrie (ATI) und die Prozessierung und Verarbeitung der aufgenommenen Verkehrsdaten ausführlich dargelegt, es wird darüberhinaus ein mit dieser Methodik erstellter Datensatz mit einer Verkehrssimulation verglichen und bewertet. Abschließend wird ein Ausblick auf zukünftige Entwicklungen der Radarfernerkundung zur Verkehrsdatenerfassung gegeben.
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FNR (Fumarat Nitratreduktase Regulator) ist der Sauerstoffsensor aus Escherichia coli. Bisher waren zwei Formen von FNR bekannt, der aktive Zustand, ein Dimer mit je einem [4Fe4S]-Zentrum und ein inaktiver Zustand, in dem FNR als Monomer mit je einem [2Fe2S]-Zentrum vorliegt. Die Untersuchungen dieser Arbeit geben nun Hinweise, dass es mit apoFNR eine dritte physiologische Form von FNR gibt. Es wurde die Entstehung von apoFNR aus [4Fe4S]•FNR untersucht und die biochemischen Eigenschaften von apoFNR charakterisiert. ApoFNR konnte in vitro zu [4Fe4S]•FNR rekonstituiert werden, hierbei konnte die Lagphase der Rekonstitution durch Zusatz von Glutaredoxinen zum Rekonstitutionsansatz verkürzt werden. FNR, dessen Cysteinreste in vivo unter aeroben bzw. anaeroben Bedingungen mit 4-Acetamido-4´-Maleimidylstilbene-2,2´Disulfonsäure markiert wurden, zeigt auf SDS-Gelen einen Shift zu einer höheren Masse im Vergleich zu unmarkiertem FNR. Allerdings trat in aeroben Zellen eine zusätzliche Bande bei einer niedrigeren Masse auf. Es waren hier also weniger Cysteinreste markierbar. Weiterhin wurde mit NreB ein potentieller Sauerstoffsensor aus Staphylococcus carnosus untersucht. Es wurden Hinweise auf ein Eisen-Schwefel-Zentrum vom FNR-Typ als Cofaktor gefunden. Der Einbau dieses Cofaktors war abhängig von der Anwesenheit der Cysteinreste in NreB, von der Cysteindesulfurase NifSAV und von Eisenionen. Der Cofaktor war sauerstoffempfindlich und beeinflusste die Autophosphorylierung von NreB.
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Thermal effects are rapidly gaining importance in nanometer heterogeneous integrated systems. Increased power density, coupled with spatio-temporal variability of chip workload, cause lateral and vertical temperature non-uniformities (variations) in the chip structure. The assumption of an uniform temperature for a large circuit leads to inaccurate determination of key design parameters. To improve design quality, we need precise estimation of temperature at detailed spatial resolution which is very computationally intensive. Consequently, thermal analysis of the designs needs to be done at multiple levels of granularity. To further investigate the flow of chip/package thermal analysis we exploit the Intel Single Chip Cloud Computer (SCC) and propose a methodology for calibration of SCC on-die temperature sensors. We also develop an infrastructure for online monitoring of SCC temperature sensor readings and SCC power consumption. Having the thermal simulation tool in hand, we propose MiMAPT, an approach for analyzing delay, power and temperature in digital integrated circuits. MiMAPT integrates seamlessly into industrial Front-end and Back-end chip design flows. It accounts for temperature non-uniformities and self-heating while performing analysis. Furthermore, we extend the temperature variation aware analysis of designs to 3D MPSoCs with Wide-I/O DRAM. We improve the DRAM refresh power by considering the lateral and vertical temperature variations in the 3D structure and adapting the per-DRAM-bank refresh period accordingly. We develop an advanced virtual platform which models the performance, power, and thermal behavior of a 3D-integrated MPSoC with Wide-I/O DRAMs in detail. Moving towards real-world multi-core heterogeneous SoC designs, a reconfigurable heterogeneous platform (ZYNQ) is exploited to further study the performance and energy efficiency of various CPU-accelerator data sharing methods in heterogeneous hardware architectures. A complete hardware accelerator featuring clusters of OpenRISC CPUs, with dynamic address remapping capability is built and verified on a real hardware.
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La tesi è suddivisa in due parti. La prima è dedicata alla determinazione della Deflessione della Verticale (DdV) in Medicina (BO). Vengono presentati tre metodi per la determinazione delle componenti della DdV. Il primo utilizza la livellazione geometrica ed il sistema GNSS, il secondo, eseguito dal dott. Serantoni, utilizza il sistema QDaedalus, messo a punto all' ETH di Zurigo ed il terzo approccio utilizza il programma ConvER, messo a disposizione dalla regione Emilia-Romagna. Nella seconda parte viene presentato un metodo per la determinazione del Coefficiente di Rifrazione Atmosferico (CRA). La procedura di calcolo è di tipo iterativo ed utilizza, oltre agli angoli zenitali, anche le distanze misurate. Il metodo è stato testato in due aree di studio. La prima nella città di Limassol (Cipro) in ambiente urbano nell' autunno 2013. La seconda in Venezia nella laguna durante l'estate 2014.
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BACKGROUND: Neovascular age-related macular degeneration (AMD) has a poor prognosis if left untreated, frequently resulting in legal blindness. Ranibizumab is approved for treating neovascular AMD. However, further guidance is needed to assist ophthalmologists in clinical practice to optimise treatment outcomes. METHODS: An international retina expert panel assessed evidence available from prospective, multicentre studies evaluating different ranibizumab treatment schedules (ANCHOR, MARINA, PIER, SAILOR, SUSTAIN and EXCITE) and a literature search to generate evidence-based and consensus recommendations for treatment indication and assessment, retreatment and monitoring. RESULTS: Ranibizumab is indicated for choroidal neovascular lesions with active disease, the clinical parameters of which are outlined. Treatment initiation with three consecutive monthly injections, followed by continued monthly injections, has provided the best visual-acuity outcomes in pivotal clinical trials. If continued monthly injections are not feasible after initiation, a flexible strategy appears viable, with monthly monitoring of lesion activity recommended. Initiation regimens of fewer than three injections have not been assessed. Continuous careful monitoring with flexible retreatment may help avoid vision loss recurring. Standardised biomarkers need to be determined. CONCLUSION: Evidence-based guidelines will help to optimise treatment outcomes with ranibizumab in neovascular AMD.
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INTRODUCTION: Apical surgery has seen continuous development with regard to equipment and surgical technique. However, there is still a shortage of evidence-based information regarding healing determinants. The objective of this meta-analysis was to review clinical articles on apical surgery with root-end filling in order to assess potential prognostic factors. METHODS: An electronic search of PubMed and Cochrane databases was performed in 2008. Only studies with clearly defined healing criteria were included, and data for at least two categories per prognostic factor had to be reported. Prognostic factors were divided into patient-related, tooth-related, or treatment-related factors. The reported percentages of healed teeth ("the healed rate") were pooled per category. The statistical method of Mantel-Haenszel was applied to estimate the odds ratios and their 95% confidence intervals. RESULTS: With regard to tooth-related factors, the following categories were significantly associated with higher healed rates: cases without preoperative pain or signs, cases with good density of root canal filling, and cases with absence or size < or = 5 mm of periapical lesion. With regard to treatment-related factors, cases treated with the use of an endoscope tended to have higher healed rates than cases without the use of an endoscope. CONCLUSIONS: Although the clinician may be able to control treatment-related factors (by choosing a certain technique), patient- and tooth-related factors are usually beyond the surgeon's power. Nevertheless, patient- and tooth-related factors should be considered as important prognostic determinants when planning or weighing apical surgery against treatment alternatives.
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Mechanical ventilation (MV) is life-saving but potentially harmful for lungs of premature infants. So far, animal models dealt with the acute impact of MV on immature lungs, but less with its delayed effects. We used a newborn rodent model including non-surgical and therefore reversible intubation with moderate ventilation and hypothesized that there might be distinct gene expression patterns after a ventilation-free recovery period compared to acute effects directly after MV. Newborn rat pups were subjected to 8 hr of MV with 60% oxygen (O(2)), 24 hr after injection of lipopolysaccharide (LPS), intended to create a low inflammatory background as often recognized in preterm infants. Animals were separated in controls (CTRL), LPS injection (LPS), or full intervention with LPS and MV with 60% O(2) (LPS + MV + O(2)). Lungs were recovered either directly following (T:0 hr) or 48 hr after MV (T:48 hr). Histologically, signs of ventilator-induced lung injury (VILI) were observed in LPS + MV + O(2) lungs at T:0 hr, while changes appeared similar to those known from patients with chronic lung disease (CLD) with fewer albeit larger gas exchange units, at T:48 hr. At T:0 hr, LPS + MV + O(2) increased gene expression of pro-inflammatory MIP-2. In parallel anti-inflammatory IL-1Ra gene expression was increased in LPS and LPS + MV + O(2) groups. At T:48 hr, pro- and anti-inflammatory genes had returned to their basal expression. MMP-2 gene expression was decreased in LPS and LPS + MV + O(2) groups at T:0 hr, but no longer at T:48 hr. MMP-9 gene expression levels were unchanged directly after MV. However, at T:48 hr, gene and protein expression increased in LPS + MV + O(2) group. In conclusion, this study demonstrates the feasibility of delayed outcome measurements after a ventilation-free period in newborn rats and may help to further understand the time-course of molecular changes following MV. The differences obtained from the two time points could be interpreted as an initial transitory increase of inflammation and a delayed impact of the intervention on structure-related genes.
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In Switzerland, the prevalence and incidence of equine piroplasma parasite (EPP) infections are unknown. In order to obtain a first insight into the prevalence, a representative sample of 689 sera of horses from Switzerland was serologically tested for the presence of antibodies directed against T. equi and B. caballi using the Indirect Fluorescence Antibody Test (IFAT). A total of 50 (7.3%) horses were seropositive for EPP: overall, the seroprevalence of T. equi was significantly higher than that of B. caballi (p=0.002). The seropositivities in indigenous horses (animals bred and raised in Switzerland) and in imported horses were 4.8% (11/230) and 8.5% (39/459), respectively. Unlike in indigenous horses, where no significant difference in seroprevalences could be observed between the two parasite species, the seroprevalence of T. equi was significantly higher (p<0.001) than that of B. caballi in imported horses. Horses imported from France, Spain and Portugal exhibited a significantly higher seroprevalence, and horses imported from Germany a significantly lower seroprevalence of EPP compared to indigenous horses. There were no associations between sex, age, weight loss, surgery or blood transfusions with T. equi and B. caballi seroprevalences. The overall seroprevalence of 7.3% clearly shows that infection with EPP is a threat to the health of the horses in Switzerland. With the presumed expansion of permissive tick vectors, EPP infections will potentially increase in importance in the future. Therefore, continuous monitoring is mandatory.
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The mechanisms causing brain damage after acute subdural hematoma (SDH) are poorly understood. A decrease in cerebral blood flow develops immediately after the hematoma forms, thus reducing cerebral oxygenation. This in turn may activate mitochondrial failure and tissue damage leading to ionic imbalance and possibly to cellular breakdown. The purpose of this study was to test whether a simple therapeutic measure, namely increased fraction of inspired oxygen (FiO2 100), and hence increased arterial and brain tissue oxygen tension, can influence brain glucose and lactate dynamics acutely after subdural hematoma in the rat. Twenty-five male Sprague-Dawley anesthetized rats were studied before, during and after induction of the SDH in two separate groups. The Oxygen group (n = 10) was ventilated with 100% oxygen immediately after induction of the SDH. The Air group (n = 10) was ventilated during the entire study with 21% oxygen. Brain microdialysate samples were analyzed for glucose and lactate. All rats were monitored with femoral arterial blood pressure catheters, arterial blood gas analysis, arterial glucose, lactate and end tidal CO2 (EtCO2). Five male Sprague-Dawley rats were sham operated to measure the effect of oxygen challenge on glucose-lactate dynamics without injury. Arterial oxygen tension in the Oxygen group was 371 +/- 30 mmHg and was associated with significantly greater increase in dialysate lactate in the first 30 min after induction of SDH. Dialysate glucose initially dropped in both groups, after SDH, but then reverted significantly faster to values above baseline in the Oxygen group. Changes in ventilatory parameters had no significant effect on dialysate glucose and lactate parameters in the sham group. Extracellular dialysate lactate and glucose are influenced by administration of 100% O2 after SDH. Dialysate glucose normalizes significantly quicker upon 100% oxygen ventilation. We hypothesize that increased neural tissue oxygen tension, in presence of reduced regional CBF, and possibly compromised mitochondrial function, after acute SDH results in upregulation of rate-limiting enzyme systems responsible for both glycolytic and aerobic metabolism. Similar changes have been seen in severe human head injury, and suggest that a simple therapeutic measure, such as early ventilation with 100% O2, may improve cerebral energy metabolism, early after SDH. Further studies to measure the generation of adenosine triphosphate (ATP) are needed to validate the hypothesis.
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The most important early pathomechanism in traumatic brain injury (TBI) is alteration of the resting membrane potential. This may be mediated via voltage, or agonist-dependent ion channels (e.g. glutamate-dependent channels). This may result in a consequent increase in metabolism with increased oxygen consumption, in order to try to restore ionic balance via the ATP-dependent pumps. We hypothesize that glutamate is an important agonist in this process and may induce an increase in lactate, potassium and brain tissue CO2, and hence a decrease in brain pH. Further we propose that an increase in lactate is thus not an indicator of anaerobic metabolic conditions as has been thought for many years. We therefore analyzed a total of 85 patients with TBI, Glasgow Coma Scale (GCS) < 8 using microdialysis, brain tissue oxygen, CO2 and pH monitoring. Cerebral blood flow studies (CBF) were performed to test the relationship between regional cerebral blood flow (rCBF) and the metabolic determinants. Glutamate was significantly correlated with lactate (p < 0.0001), potassium (p < 0.0001), brain tissue pH (p = 0.0005), and brain tissue CO2 (p = 0.006). rCBF was inversely correlated with glutamate, lactate and potassium. 44% of high lactate values were observed in brain with tissue oxygen values, above the threshold level for cell damage. These results support the hypothesis of a glutamate driven increase in metabolism, with secondary traumatic depolarization and possibly hyperglycolysis. Further, we demonstrate evidence for lactate production in aerobic conditions in humans after TBI. Finally, when reduced regional cerebral blood flow (rCBF) is observed, high dialysate glutamate, lactate and potassium values are usually seen, suggesting ischemia worsens these TBI-induced changes.
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The flammability zone boundaries are very important properties to prevent explosions in the process industries. Within the boundaries, a flame or explosion can occur so it is important to understand these boundaries to prevent fires and explosions. Very little work has been reported in the literature to model the flammability zone boundaries. Two boundaries are defined and studied: the upper flammability zone boundary and the lower flammability zone boundary. Three methods are presented to predict the upper and lower flammability zone boundaries: The linear model The extended linear model, and An empirical model The linear model is a thermodynamic model that uses the upper flammability limit (UFL) and lower flammability limit (LFL) to calculate two adiabatic flame temperatures. When the proper assumptions are applied, the linear model can be reduced to the well-known equation yLOC = zyLFL for estimation of the limiting oxygen concentration. The extended linear model attempts to account for the changes in the reactions along the UFL boundary. Finally, the empirical method fits the boundaries with linear equations between the UFL or LFL and the intercept with the oxygen axis. xx Comparison of the models to experimental data of the flammability zone shows that the best model for estimating the flammability zone boundaries is the empirical method. It is shown that is fits the limiting oxygen concentration (LOC), upper oxygen limit (UOL), and the lower oxygen limit (LOL) quite well. The regression coefficient values for the fits to the LOC, UOL, and LOL are 0.672, 0.968, and 0.959, respectively. This is better than the fit of the "zyLFL" method for the LOC in which the regression coefficient’s value is 0.416.