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  • 11
    Electronic Resource
    Electronic Resource
    Blood component use in critically ill patients (2002)
    Oxford, UK : Blackwell Science Ltd
    Anaesthesia 57 (2002), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Summary This prospective observational study was conducted to assess the current transfusion practice in critically ill patients. One thousand two hundred and forty-seven consecutive critically ill patients admitted between February 1999 and October 1999 were included in the study. Overall 666 (53%) patients were administered red cells. Transfused patients had significantly higher intensive care unit␣mortality but also had higher Acute Physiology and Chronic Health Evaluation II scores and longer durations of stay. The average pretransfusion haemoglobin concentration was 〈 9 g.dl−1 in 75% of transfusion episodes. The common indications for transfusion were low haemoglobin (72%) and haemorrhage (25%). Overall, 202 (16%) and 281 (22%) of the patients were transfused platelets and fresh frozen plasma, respectively. The indications for transfusion were haemorrhage, low platelet counts, prolonged prothrombin time or to provide cover for invasive interventions. Most platelet transfusions were given at values in the order of 50–100 × 109.l−1. The pretransfusion platelet count varied according to the indications for transfusion. This study showed that transfusion practice is consistent and that in general there does not seem to be an excessive use of blood components in critically ill patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2044.2002.02514.x
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  • 12
    Electronic Resource
    Electronic Resource
    The effects of feeding by Oniscus asellus on leaf litter sulfur constituents (1987)
    Springer
    Biology and fertility of soils 3 (1987), S. 107-111 
    Details
    ISSN: 1432-0789
    Keywords: Oniscus asellus ; Leaf litter ; Acer negundo ; A. saccharum ; Fagus grandifolia ; Picea rubens ; Tsuga canadensis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Geosciences , Agriculture, Forestry, Horticulture, Fishery, Domestic Science, Nutrition
    Notes: Summary Feeding by the isopod, Oniscus asellus, produced changes in the sulfur constituents of leaf litter substrates (Acer negundo, A. saccharum, Fagus grandifolia, Picea rubens, and Tsuga canadensis). Isopod consumption of leaf litter generally accelerated the mineralization of carbon-bonded S and increased the formation of ester sulfate in all substrates. After the isopod egestion of A. negundo leaves, fecal decomposition over 6 weeks increased total S concentration from 68 to 120 μmol S/g due to the catabolism of organic carbon. During the same period sulfate decreased from 34 to 20 μmol S/g and carbon-bonded S increased from 34 to 100 μmol S/g. Thus the total S pool in aged feces became enriched with organic S (83% of total S). Macroinvertebrate consumption accelerated the transformation of S constituents and the carbon-bonded S concentration approached that of the Oa organic horizon of a northern hardwood forest.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00260589
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  • 13
    Electronic Resource
    Electronic Resource
    The effects of feeding byOniscus asellus (Isopoda) on nutrient cycling in an incubated hardwood forest soil (1989)
    Springer
    Biology and fertility of soils 7 (1989), S. 239-246 
    Details
    ISSN: 1432-0789
    Keywords: Nutrient cycling ; Oniscus asellus ; Hardwood forest soil ; Leaching ; Macrofauna
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Geosciences , Agriculture, Forestry, Horticulture, Fishery, Domestic Science, Nutrition
    Notes: Summary Oniscus asellus produced changes in the nutrients leached from Oie and Oa horizons of a hardwood forest soil. Soil with isopods lost more K+ (54%) from the Oie horizon and more Ca2+ (25%), Mg2+ (40%), and water-extractable S (23%) from the Oa horizon than soil without isopods. In contrast, soils with isopods lost less Ca2+ (39076) from the Oie horizon and less dissolved C-bonded S (33%) from the Oa horizon than soil without isopods. In addition, the Oia and Oa horizons exhibited different nutrient dynamics. When isopods were present, the Oa horizon leachates accumulated more Na+ K+, Ca2+, Mg2+, NO3 − , water-soluble SO4 2−, and dissolved C-bonded S, and the Oie horizon retained more of these nutrients. The type of leaching solution also had a major effect on nutrients. Leaching with a simulated soil solution resulted in smaller nutrient losses for K+ and Mg2+ in both horizons and for Na+, Ca2+, and NO3 − in the Oa horizon than leaching with distilled water.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00709655
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  • 14
    Electronic Resource
    Electronic Resource
    Urodynamic evaluation of urethral opening area in females with stress incontinence (1993)
    Springer
    International urogynecology journal 4 (1993), S. 335-341 
    Details
    ISSN: 1433-3023
    Keywords: Urethral compliance ; Urethral modeling ; Urinary diagnostics ; Urodynamics
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Urodynamic evaluation has been helpful in the diagnosis of stress incontinence in female patients. We evaluated two new parameters using standard urodynamic measures that were recorded during micturition. These two parameters were obtained by fitting a classic fluid dynamic equation for flow through short rigid tubes to published data of voiding, videourodynamics. This formula, an area equivalent factor female (AEFf) indicates urethral cross-sectional opening area based on bladder pressure and flow measures. The first parameter, maximal urethral opening or maximal AEFf, was observed at maximal flow, and this value further divided by the detrusor pressure determined the second parameter, the urethral total compliance. A preliminary retrospective study was conducted using detrusor pressure and urine flow data from stress incontinent (n=14) and continent (n=5) female patients. There was a trend toward greater maximal urethral opening at 14.2±5.9 mm2 in the stress incontinent group compared to the continent group, 9.2±2.9 mm2 (p=0.09). The stress incontinent group also showed a strong trend (p=0.09) toward greater total compliance values of 0.78±0.5 mm2/ cmH2O, compared to 0.35±0.2 mm2/cmH2O in the continent group. These parameters may have potential in the evaluation and understanding of stress incontinence.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00387381
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  • 15
    Electronic Resource
    Electronic Resource
    Acute renal failure following cardiopulmonary bypass: a changing picture (2000)
    Springer
    Intensive care medicine 26 (2000), S. 565-571 
    Details
    ISSN: 1432-1238
    Keywords: Key words Cardiopulmonary bypass ; Acute renal failure
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: To assess the incidence of acute renal failure (ARF) developing perioperatively in adult patients requiring cardiopulmonary bypass surgery (CPB) and to make comparisons with data from the same institution published earlier. Design: Prospective, observational. Setting: Tertiary referral centre for cardiopulmonary medicine. Patients and participants: All patients admitted to the intensive care unit (ICU) who developed ARF perioperatively necessitating continuous veno-venous haemofiltration (CVVH) during the 24 months January 1997–December 1998. Interventions: None. Measurements and results: Of 2337 adult patients undergoing cardiac surgery, 47 (2.0 %) needed CVVH. Patients were excluded from analysis who underwent cardiac transplantation (n = 4), pericardial surgery (n = 3) or insertion of a left ventricular assist device (n = 1). Of the remaining 39, 21 patients died in ICU (53.8 % mortality). Relatively more non-survivors suffered from diabetes, hypertension and preoperative renal dysfunction. A previous report from our Unit revealed that, in 1989–90, 2.7 % of all patients undergoing CPB required CVVH with an in-hospital mortality of 83 %. The current study population were older (65.3 vs 56.0 years in 1990), and more severely ill as evidenced by a higher percentage of patients requiring redo (30 % vs 8.6 % in 1990) and emergency (50 % vs 25.7 % in 1990) surgery. Conclusions: The need for CVVH following CPB may be diminishing despite increased risk factors. ARF-associated mortality in these circumstances is falling.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001340051205
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  • 16
    Electronic Resource
    Electronic Resource
    The use of radionuclide techniques in the assessment of alveolar-capillary membrane permeability on the intensive care unit (1990)
    Springer
    Intensive care medicine 16 (1990), S. 363-371 
    Details
    ISSN: 1432-1238
    Keywords: Intensive care ; Radionuclides ; Lung injury
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Conclusion Three isotopic methods of estimating alveolar-capillary membrane permeability have been described. The first, radiolabelled HSA, is crude, and appears to have no clinical applications. Pulmonary99mTc-DTPA clearance studies are relatively easy to perform, but suffer from their high sensitivity and variations in technique from centre to centre. The double isotopic measurement of PAI has only been adopted by a few centres, but may offer reliable assessment of the pulmonary endothelial permeability which is probably an early marker of acute lung injury. None of these techniques has proved predictive of outcome in ARDS. However, trials where alveolar-capillary membrane permeability is assessed before clinical evidence of lung injury is apparent have yet to be conducted. Thus at present, methods of assessing alveolar-capillary membrane permeability, particularly capillary endothelial integrity, may prove to be more useful in monitoring new therapeutic interventions in lung injury, rather predicting outcome.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01735173
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  • 17
    Electronic Resource
    Electronic Resource
    Blood lactate and mixed venous-arterial PCO2 gradient as indices of poor peripheral perfusion following cardiopulmonary bypass surgry (1991)
    Springer
    Intensive care medicine 17 (1991), S. 320-324 
    Details
    ISSN: 1432-1238
    Keywords: Blood lactate ; Acid base balance ; Cardiopulmonary bypass
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Conventional indices of tissue perfusion after surgery involving cardiopulmonary bypass (CPB) may not accurately reflect disordered cell metabolism. Venous hypercarbia leading to an increased veno-arterial difference in CO2 tensions (V-aCO2 gradient) has been shown to reflect critical reductions in systemic and pulmonary blood flow that occur during cardiorespiratory arrest and septic shock. We therefore measured plasma lactate levels and V-aCO2 gradients in 10 patients (mean age 57.2 years) following CPB and compared them with conventional indices of tissue perfusion. Plasma lactate levels, cardiac index (CI) and oxygen uptake $$(\dot VO_2 )$$ all increased significantly (p〈0.05 vs baseline levels) up to 3h following surgery. Oxygen delivery $$(\dot DO_2 )$$ did not change. Plasma lactate levels correlated significantly with CI (r=0.47,p〈0.01). V-aCO2 fell significantly with time (p〈0.01 vs baseline). There was an inverse relationship between V-aCO2 and cardiac index and V-aCO2 and lactate (r=−0.37,p〈0.05;r=−0.3,p〈0.05 respectively). We conclude that blood lactate, CI and $$\dot VO_2 $$ increase progressively following CPB. An increase in lactate was associated with a decrease in V-aCO2. An increase in V-aCO2 was not therefore associated with evidence of inadequate tissue perfusion as indicated by an increased blood lactate concentration.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01716189
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  • 18
    Electronic Resource
    Electronic Resource
    Organization of corneal afferent axons in the trigeminal nerve root entry zone in the cat (1987)
    Springer
    Experimental brain research 68 (1987), S. 411-416 
    Details
    ISSN: 1432-1106
    Keywords: Trigeminal organization ; Cornea ; HRP
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Experiments were carried out in cats to learn the location of sensory axons from the cornea in the trigeminal nerve root just prior to its entry into the brainstem. HRP injected into the cornea labelled these axons and indicated they were not restricted to the ophthalmic division of the nerve root as had been indicated from previous studies. These findings, if representative of other branches of this nerve, offer a partial explanation for the variable preservation of function following transection of an entire division of the trigeminal nerve root in cases of trigeminal neuralgia.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00248806
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  • 19
    Electronic Resource
    Electronic Resource
    Continuous veno-venous haemofiltration following cardio-pulmonary bypass (1993)
    Springer
    Intensive care medicine 19 (1993), S. 290-293 
    Details
    ISSN: 1432-1238
    Keywords: Acute renal failure ; Cardio-pulmonary bypass ; Haemofiltration
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective To study the impact of continuous veno-venous haemofiltration on survival in patients with acute renal failure (ARF) following cardio-pulmonary bypass (CPB) surgery. Design A retrospective study of all patients requiring haemofiltration after CPB over a 2 year period. Setting A 20 bedded, adult cardothoracic intensive care unit in a postgraduate teaching hospital. Patients 35 patients (26 male, age range 24–74 years) required haemofiltration (2.7% of the total number of patients undergoing CPB). Main results Cardiovascular failure post CPB was the commonest causes of ARF (n=16). Indications for haemofiltration were ureamia (21), oligo-anuria (11), volume overload (2) and hyperkalaemia (1). Mean time from CPB to the initiation of haemofiltration was 8 days (range 0–15 days). Mean urea was 30 mmol/l and creatinine 362 μmol/l immediately prior to treatment. Urea was well-controlled in all patients, although 2 needed haemodiafiltration. Twenty-six patients died during their admission to the ICU (74% mortality). A further 3 patients died during their hospital admission, following discharge from ICU. Outcome was particularly poor in patients with cardiovascular failure following CPB (16 cases, 0 survivors). Survivors tended to commence filtration earlier (mean of 4 vs 7 days for non-survivors) and required treatment for a mean period of 8 days (range 1–26 days). Survival was determined by the number of failed organ systems at the start of haemofiltration. Thus, 100% of patients with single system failure survived, compared to only 10% with 3 or more system failure. Conclusions Despite the theoretical advantages of haemofiltration and the effective control of uraemia the mortality associated with ARF following CPB remains high and is probably determined by the number of failed organs systems.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01690550
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  • 20
    Electronic Resource
    Electronic Resource
    Coordination of the cell-specific distribution of the four subunits of glycine decarboxylase and of serine hydroxymethyltransferase in leaves of C3-C4 intermediate species from different genera (1993)
    Springer
    Planta 190 (1993), S. 468-473 
    Details
    ISSN: 1432-2048
    Keywords: C3-C4 intermediate species (Flaveria, Moricandia, Panicum) ; C4 evolution ; Glycine decarboxylase (localization) ; Photorespiration ; Serine hydroxymethyltransferase (localization)
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology
    Notes: Abstract The cell-specific distribution of the four subunit proteins (P, L, T and H) of glycine decarboxylase (GDC) and of serine hydroxymethyltransferase (SHMT) has been studied in the leaves of C3-C4 intermediate and C4 species of three genera (Flaveria, Moricandia and Panicum) using immunogold localization. Antibodies raised against these proteins from pea leaf mitochondria were used to probe Western blots of total leaf proteins of F. linearis Lag., M. arvensis (L.) DC and P. milioides Nees ex Trin. (C3-C4), and F. trinervia (Spring.) Mohr and P. miliaceum (L.) (C4). For all species, each antibody recognised specifically a protein of similar molecular weight to that in pea leaves. In leaves of M. arvensis the P protein was present in the mitochondria of the bundle-sheath cells but was undetectable in those of the mesophyll, whereas the L, T and H proteins and SHMT were present in both cell types. The density of immunogold labelling of SHMT on the mitochondria of mesophyll cells was less than that on those of the bundle-sheath cells, which correlates with the relative activities of SHMT in these cell types. These data reveal that the lack of functional GDC in the mesophyll cells of M. arvensis, which is the principal biochemical reason for reduced photorespiration in this species, is due to the loss of a single subunit protein. This lack of coordinate expression of the subunit proteins of GDC within a photosynthetic cell represents a clear difference between M. arvensis and other C3 and C3-C4 species. None of the GDC proteins was detectable in the mesophyll cells of the C3-C4 and C4 Flaveria and Panicum species but all were present in the bundle-sheath cells. The differences in the distribution of the GDC proteins in leaves of the C3-C4 species studied are discussed in relation to the evolution of photosynthetic mechanisms.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00224785
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