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At least 325 records · Page 18Linked to original sources
PubMed2001

Recombinant soluble P-selectin glycoprotein ligand 1 moderates local and remote injuries following experimental lower-torso ischaemia.

BACKGROUND: A central role for the polymorphonuclear leucocyte (PMN) in skeletal muscle ischaemia-reperfusion has been demonstrated by the observation that PMN depletion reduced local and remote pulmonary vascular permeability. This study investigated the role of recombinant soluble P-selectin glycoprotein ligand-immunoglobulin fusion protein (rPSGL-Ig), a P- and E-selectin antagonist, in moderating injury. METHODS: Mice underwent 2 h of hindlimb ischaemia and 3 h of reperfusion. Muscle and lung vascular permeability index (PI) was assessed by extravasation of (125)I-radiolabelled albumin. Lung myelo peroxidase (MPO) activity was also measured. RESULTS: In mice treated with rPSGL-Ig 1 mg/kg before reperfusion (n = 12) muscle PI was reduced by 40 per cent, whereas it was moderated by 20 per cent in animals treated 30 min after reperfusion (n = 15). Lung PI in mice treated with rPSGL-Ig before (n = 12) and 30 min after (n = 15) reperfusion was reduced by over 99 and 98 per cent respectively. Lung MPO activity in mice treated with rPSGL-Ig before (n = 10) and 30 min after (n = 12) reperfusion was reduced by 68 and 58 per cent respectively. Treatment with rPSGL-Ig 1 h after reperfusion, or with m20ek.Fc 1 mg/kg (n = 9; negative control for rPSGL-Ig which is inactive for selectin binding) before reperfusion failed significantly to moderate local or remote organ injury. CONCLUSION: Selectin blockade moderated local skeletal muscle and remote lung injury following hindlimb ischaemia--reperfusion. Significantly, delayed antiselectin therapy also decreased injury.

Animals↗
PubMed2001

A psychoanalytically informed conversation with a woman and her husband following major surgery for cancer of her neck and torso.

AIMS OF THE PAPER: This paper explores psychoanalytic ideas of containment as described by Wilfred Bion and applies them understanding the concerns of a woman with serious illness and her husband. A case vignette shows psychoanalytic thinking in context. The paper explores verbatim exchanges that took place in a room just off a hospital ward and offers a psychoanalytically informed analysis. RATIONALE: This discussion suggests that the impact of physical illness is such that there is potential for the seriously ill to saturate health workers in anxiety and raw feelings. To protect themselves, nurses and other health workers could sometimes unconsciously overlook the emotional care of people in favour of routines, physical aspects of care and other demonstrable methods of treatment. CONCLUSIONS: Drawing on the work of Isabel Menzies Lyth, the discussion concludes by recommending that environments are needed in which a person with serious illness or family member can be helped to make sense of his or her experiences and so integrate them into a meaningful life continuum. Similar conditions are perhaps needed for nurses or other health workers. Appropriate methods of work discussions in clinical supervision might conceivably provide these important requirements.

Adaptation, Psychological↗
PubMed1996

Evaluation of artificial neural network modelling to predict torso muscle activity.

Owing to the complexities involved in obtaining direct measures of in vivo muscle forces, validation of predictive models of muscle activity has been difficult. An artificial neural network (ANN) model had been previously developed for the estimation of lumbar muscle activity during moderate levels of static exertion. The predictive ability of this model is evaluated in this study using several techniques, including comparison of response surfaces and composite statistical tests of values derived from model output, with multiple EMG experimental datasets. ANN-predicted activation levels were accurately modelled to within 3% across a range of experiments and levels of combined flexion/extension and lateroflexion loadings. The results indicate both a high degree of consistency in the averaged muscle activity measured in several different experiments, and substantiate the ability of the ANN model to predict generalized recruitment patterns. It also is suggested that the use of multiple comparison methods provides a better indication of model behaviour and prediction accuracy than a single evaluation criterion.

Databases, Factual↗
PubMed2006

A comparison of volunteers and dummy upper torso kinematics with and without shoulder belt slack in a low speed side/pre-roll environment.

OBJECTIVE: The objective of this study was to compare the occupant and dummy kinematics in a low-speed lateral environment with and without shoulder belt slack. METHODS: A buck of a small European car was mounted on a side impact sled. The parameters evaluated were pulses, sitting location, and belt slack. A total of 24 tests were carried out. Three 50th-percentile male volunteers and one Hybrid III 50th-percentile male were tested. The pulses consisted of Pulse 1:+/- 0.7 g's pulse and Pulse 2: a -0.9 g pulse to simulate low-speed pre-roll/side events. Both pulses had a duration of 500 msec. RESULTS: The peak lateral head excursion was higher in the far-side occupants than in the near-side occupants. Furthermore, for the far-side volunteers, lateral head displacements were lower in the no-slack condition than in the slack condition, at 388 +/- 64 mm and 455 +/- 84 mm respectively for Pulse 1 and at 138 +/- 2 mm and 207 +/- 70 mm for Pulse 2. The timing required to reach peak lateral displacement was higher in Pulse 1 than in Pulse 2. In comparison to the volunteers, the Hybrid III dummy lateral motion was lower. The peak lateral displacement in Pulse 1 was 231 mm with slack and 194 mm without and 98 mm and 107 mm for Pulse 2, respectively. CONCLUSIONS: The results obtained in this study indicate that removing seatbelt slack would be more beneficial for far-sided occupants than near-sided. They also point to the lack of biofidelity of the Hybrid III dummy in low g lateral pulses.

Accidents, Traffic↗
PubMed1987

Pulmonary hypertension and leukosequestration after lower torso ischemia.

Ischemia stimulates thromboxane (Tx) synthesis. This study tests the hypothesis that the cardiopulmonary dysfunction that may follow aortic declamping is related to Tx. Anesthetized dogs (N = 15) were subjected to 4 hours of infrarenal aortic cross-clamping. In untreated control animals (N = 7), plasma levels of TxB2 rose from 654 +/- 74 pg/mL to 1238 +/- 585 pg/mL at 5 min (p less than 0.05), and to 3174 +/- 912 pg/mL 3 hours after declamping (p less than 0.05). Mean pulmonary artery pressure (MPAP) rose 5 min after declamping from 13 +/- 2 mmHg to 21 +/- 2 mmHg (p less than 0.05). Cardiac Index (CI) declined during ischemia from 181 +/- 30 mL/kg.min to 128 +/- 16 mL/min.kg (p less than 0.05), and to 80 +/- 8 mL/min.kg after 4 hours of reperfusion (p less than 0.05). Platelet counts declined but platelets labeled with In 111 did not accumulate in the lungs, whereas quantitative counts of polymorphonuclear leukocytes (PMN) in the lungs 4 hours after declamping yielded 213 +/- 33 PMN/25 high power fields (HPF) in dependent areas of the lung and 153 +/- 26 PMN/25 HPF in nondependent areas. The wet/dry weight ratio of the lungs was not elevated, although foci of proteinaceous exudate and PMNs in alveoli were noted. Another group of dogs (N = 8) were pretreated by random choice with the Tx synthase inhibitor OKY-046 2 mg/kg IV every 2 hours, which led to: lower TxB2 levels at baseline 95 +/- 35 pg/mL (p less than 0.05), 5 min after ischemia 140 +/- 93 pg/mL and after 3 hours of reperfusion 122 +/- 36 (p less than 0.05); lower MPAP, 16 +/- 2 mmHg (p less than 0.05); higher CI throughout (p less than 0.05); normal histology and reduced pulmonary PMN sequestration both in dependent 127 +/- 15 PMN/25 HPF and nondependent areas of the lungs 95 +/- 11 PMN/25 HPF (p less than 0.05). In animals undergoing sham ischemia (N = 3), levels of TxB2 and cardiopulmonary function remained unchanged from baseline. There were 150 PMN/25 HPF in dependent and 85 PMN/25 HPF in nondependent lung areas. The results indicate that ischemia-generated Tx mediates a rise in MPAP, a fall in CI, and PMN entrapment in the lungs.

Animals↗
PubMed1999

Comparison of sliced and whole lung sets for the LLNL and JAERI torso phantoms using GE detectors.

The performance characteristics of sliced lung sets were compared to lung sets with activity homogeneously distributed throughout the lung tissue substitute material. The activity estimate from planar sources differs from the estimate from homogeneous sources by a factor of 0.88 to 1.09 depending on the photon energy. This error is small compared to other uncertainties commonly encountered in lung counting, i.e., activity deposition in the lung, detector placement, size difference between individuals, etc. Sliced lung sets could be used instead of homogeneous lung sets to test or provide an interim calibration for a lung counting system.

Calibration↗
PubMed2003

Comparison of sliced lungs with whole lung sets for a torso phantom measured with Ge detectors using Monte Carlo simulations (MCNP).

Lung counters are generally used to measure low energy photons (<100 keV). They are usually calibrated with lung sets that are manufactured from a lung tissue substitute material that contains homogeneously distributed activity; however, it is difficult to verify either the activity in the phantom or the homogeneity of the activity distribution without destructive testing. Lung sets can have activities that are as much as 25% different from the expected value. An alternative method to using whole lungs to calibrate a lung counter is to use a sliced lung with planar inserts. Experimental work has already indicated that this alternative method of calibration can be a satisfactory substitute. This work has extended the experimental study by the use of Monte Carlo simulation to validate that sliced and whole lungs are equivalent. It also has determined the optimum slice thicknesses that separate the planar sources in the sliced lung. Slice thicknesses have been investigated in the range of 0.5 cm to 9.0 cm and at photon energies from 17 keV to 1,000 keV. Results have shown that there is little difference between sliced and whole lungs at low energies providing that the slice thickness is 2.0 cm or less. As the photon energy rises the slice thickness can increase substantially with no degradation on equivalence.

Calibration↗
PubMed1991

Gut bacterial translocation via the portal vein: a clinical perspective with major torso trauma.

Animal studies implicate gut bacterial translocation via the portal vein as a major factor in the pathogenesis of postinjury multiple organ failure (MOF). We therefore inserted portal vein catheters for sequential blood sampling in the operating room, at 6, 12, 24, and 48 hours, and 5 days postoperatively in 20 injured patients (13 blunt, seven penetrating; mean age, 34 years) requiring emergent laparotomy and who were at known risk for MOF. The mean Revised Trauma Score was 6.4 +/- 0.4, and the Injury Severity Score, 29.3 +/- 2.3. Twelve (60%) patients arrived in shock (SBP less than 90 torr). Eight (2%) of 212 portal blood cultures were positive; seven were presumed contaminants. The only positive systemic culture (total, 212) was a Staphylococcus aureus on day 5 in a patient with a concurrent staphyloccal pneumonia. In the first 48 hours, we could not detect endotoxin in portal or systemic blood. Additionally, simultaneous portal and systemic blood levels of complement fragment C3a, tumor necrosis factor, and interleukin-6 were nearly identical and, specifically, were not different in those patients who developed MOF. In summary, this prospective clinical study has not confirmed portal or systemic bacteremia within the first 5 days postinjury, despite an eventual 30% incidence of MOF.

Abdominal Injuries↗
PubMed2000

Communicating with the family: the risks of medical radiation to conceptuses in victims of major blunt-force torso trauma.

BACKGROUND: Trauma surgeons must balance the risk and benefits of diagnostic radiographic procedures on potentially pregnant patients and should know the range and likelihood of effects that radiation might have on pregnancy. METHODS: We present guidelines for assessing such radiation risks. Knowledge of a patient's pregnancy status and an estimate of radiation dose to the conceptus (low, < 10 mGy [milligray]; intermediate, 10-250 mGy; high, > 250 mGy) allow provisional assessment of radiation-induced risks. RESULTS: Dose estimates may be estimated at 2 mGy per exposure (radiographs), 5 mGy per slice (computed tomography), and 10 mGy per minute of fluoroscopy, when the conceptus is within the x-ray field. A formal radiation exposure assessment is appropriate when provisional estimates exceed 10 mGy. CONCLUSION: A simple qualitative dose assessment can inform clinical decisions and guide appropriate triage to more formal quantitative assessment.

Family↗