RESUMEN
In this case report, we present a successful case of en bloc heart-lung transplant in a patient with advanced cardiopulmonary respiratory failure from amiodarone-associated pulmonary fibrosis that occurred post-left ventricular assist device implantation.
Asunto(s)
Corazón Auxiliar , Trasplante de Corazón-Pulmón/métodos , Fibrosis Pulmonar/inducido químicamente , Amiodarona/efectos adversos , Antiarrítmicos/efectos adversos , Insuficiencia Cardíaca/etiología , Insuficiencia Cardíaca/cirugía , Humanos , Masculino , Persona de Mediana Edad , Insuficiencia Respiratoria/etiología , Insuficiencia Respiratoria/cirugía , Resultado del TratamientoRESUMEN
Orthotopic heart transplantation is the criterion standard treatment for end-stage heart failure and the number of recipient candidates has been increasing. Despite this increasing demand, there is limited donor organ supply. In order to surmount this challenge, we propose harvesting donor hearts from more distant locations and accepting longer cold ischemic times. The usual accepted total ischemic time limit for the transplanted human heart is up to 4 hours. Here, we report the successful use of a donor heart from 1268 miles away with a total allograft ischemic time greater than 6 hours.
Asunto(s)
Isquemia Fría , Trasplante de Corazón/métodos , Donantes de Tejidos/provisión & distribución , Anciano , Humanos , Masculino , Factores de Tiempo , Trasplante HomólogoRESUMEN
A novel secure holographic memory system with polarization encoding is proposed. Two-dimensional original data are encoded as a two-dimensional polarization distribution. The polarization state at each pixel is scrambled by a mask that changes the polarization state into a random state. The mask can rotate the direction of the principal axes of the elliptically polarized light and can change the phase retardation at each pixel. The light with the random polarization state is stored as a hologram that can produce the vector phase-conjugate beam. In the decryption the vector phase-conjugation readout can recover the original polarization state by use of the same mask used in the encryption. Experimental results of encryption and decryption with a bacteriorhodopsin film are presented.
RESUMEN
In enflurane-anesthetized subjects, controlled hypotension was induced by the intravenous administration of prostaglandin E1 (PGE1), and its effects on the cerebral blood flow (CBF) and intracranial pressure (ICP) were investigated by using changes in the flow velocity of the ophthalmic artery (OPA) and cerebrospinal fluid pressure (CSFP) as indices, respectively. After measurements of these hemodynamic variables, the spinal subarachnoidal compliance was also determined, and its relationship with the flow velocity in the ophthalmic artery and CSFP was investigated. The results of the study suggest that PGE1 causes no significant changes in CSFP and that cerebral blood flow is well-maintained despite a reduction in cerebral perfusion pressure.
Asunto(s)
Alprostadil/farmacología , Presión del Líquido Cefalorraquídeo/efectos de los fármacos , Circulación Cerebrovascular/efectos de los fármacos , Adaptabilidad/efectos de los fármacos , Espacio Subaracnoideo/efectos de los fármacos , HumanosRESUMEN
The degree of muscle relaxation required for the abdominal surgery should differ at different phase of operation. To test this hypothesis muscle relaxation was assessed subjectively by the surgeon and the results were compared with quantitative observations of the degree of response depression to train of four (t4) stimulation at various stages of surgery. Maximum relaxation, with a t4 ratio of less than 10%, was required immediately after the skin incision and during closure of the abdominal wall, while the requirement was minimal during the major part of surgery when the intra-abdominal procedures were performed.
RESUMEN
Some reports have shown that diazepam potentiates the neuromuscular blocking effect of pancuronium in in vitro experiments. Another report shows that a receptor for diazepam is present in the rat diaphragm and there is a direct blocking effect by diazepam of the neuromuscular junction of diaphragm muscle. Such interaction, consequently, may be related to the peripheral diazepam receptor. Based on such a hypothesis, RO15-1788, a recently developed diazepam antagonist, was used in an attempt to clarify the mechanism of such interaction. Hemidiaphragm preparations were immersed in an organ bath filled with Krebs solution which was bubbled with 95% oxygen and 5% carbon dioxide at 37 degrees C. The phrenic nerves were stimulated supramaximally at 0.1 Hz intervals. Mechanical twitch responses were recorded. The preparations were divided into five groups (group 1: treated with only 30 microM of diazepam, group 2: treated with 30 microM of diazepam and 3.0 microM of RO15-1788, group 3: treated with 30 microM of diazepam and 4.0 microM of RO15-1788, group 4: treated with 30 microM of diazepam and 6.6 microM of RO15-1788, group 5: without diazepam and RO15-1788). Cumulative dose-response curves were determined for pancuronium, and ED50 was calculated from each of the 5 curves. There was almost no effect of RO15-1788 in group 2, but RO15-1788 increased ED50 for 20% in group 3 (ED50 3.04 +/- 0.10 microM) and for 35% in group 4 (ED50 3.12 +/- 0.07 microM), respectively, as compared with group 1 (ED50 2.76 +/- 0.08 microM). This phenomenon shows that diazepam was antagonized significantly by RO15-1788.(ABSTRACT TRUNCATED AT 250 WORDS)