Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “WISCONSIN”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 109 records · Page 6Linked to original sources
PubMed1990

HIV-1 among childbearing women and newborns in Wisconsin.

To estimate the prevalence of antibody to human immunodeficiency virus-type 1 (HIV-1) among Wisconsin childbearing women (CBW), a continuous blinded HIV-1 seroprevalence survey is being conducted. This survey uses dried blood specimens obtained from infants as part of the Wisconsin Newborn Screening Program. From February 1989 through March 1990, 79,546 specimens from Wisconsin residents were tested for HIV-1 antibody, 21 (0.026%) were HIV-1 seropositive. Among specimens obtained from Milwaukee County CBW, 15 (0.076%) of 19,781 were HIV-1 seropositive compared to 6 (0.010%) of 59,765 obtained from other Wisconsin counties. After adjusting for maternal residence, Wisconsin minority CBW were six times more likely to be HIV-1 seropositive when compared to white CBW. The survey results underscore the need for strategies to prevent HIV-1 infection that focus on women of childbearing age in Wisconsin.

Adolescent↗
PubMed1996

Family practice residency training capacity in Wisconsin: current status and future projections.

BACKGROUND: High quality health care depends on superior training and outstanding residency opportunities for new physicians of all types, especially those entering family practice. But concern over the availability of adequate opportunity has caused the medical community concern across the country. Wisconsin is no different. To estimate future residency needs in the Badger State, we examined recent trends in specialty selection and information gathered from 1995 medical school graduates entering family practice residency training here and in other states. We surveyed all Wisconsin medical school graduates entering family practice training positions in July 1995, asking them to rank in-state and out-of-state programs, as well as graduates' motivations for selecting those programs. RESULTS: Response rates to our surveys were exceptional. A full 86% (n = 30) those entering residency in Wisconsin and 95% (n = 18) for those in out-of-state programs responded. One graduate who entered a Wisconsin program ranked an out-of-state program higher and one graduate who entered an out-of-state program ranked a Wisconsin program higher than their ultimate residency sites. Not surprisingly, the variable most predictive of whether students pursued training in Wisconsin rather than out-of-state was the student's state of residency before entering medical school. CONCLUSIONS: The resulting trends show positive trends toward state-based family practice training, but may not be as optimistic as experts first predicted. If interest in family practice rises to goals set by the state's medical schools, more training positions will be needed, but not as many as proposed in medical school plans to the state Legislature.

Career Choice↗
PubMed1993

Extended cardiopulmonary preservation: University of Wisconsin solution versus Bretschneider's cardioplegic solution.

Application of the University of Wisconsin cold storage solution has rapidly expanded to include medium-term to long-term preservation of virtually all intraabdominal organs. Its use in intrathoracic organ transplantation has also been suggested. We therefore examined the efficacy of the University of Wisconsin solution in a primate allotransplantation model for preservation of hearts, and as a simple single-solution system for static preservation of heart-lung blocks, for periods of ischemia ranging from 6 to 24 hours. For comparison, we employed the histidine-tryptophane-ketoglutarate cardioplegic solution of Bretschneider. University of Wisconsin solution provided superior results with regard to clinical outcome and hemodynamic recovery of hearts after ischemic periods of up to 16 hours. This was in contrast to Bretschneider's solution, which allowed storage of hearts for periods of only up to 10 hours. Heart-lung blocks were equally well preserved with either University of Wisconsin or Bretschneider's solution after 6 to 12 hours, although the University of Wisconsin solution group exhibited a more notable increase in pulmonary water content. This was in accordance with histological data, which suggested that, although hemodynamic recovery of hearts stored for periods longer than 10 hours was poor, preservation of pulmonary ultrastructure was far superior using Bretschneider's solution as compared with University of Wisconsin solution after an ischemic period of up to 16 hours.

Adenosine↗
PubMed2006

Pancreas preservation with the University of Wisconsin versus Celsior solutions.

INTRODUCTION: The use of Celsior solution for organ preservation has not been thoroughly studied in pancreas transplantation. The aim of this study was to compare University of Wisconsin and Celsior solutions for preservation of pancreas grafts. PATIENTS AND METHODS: From March 1995 to December 2005, 72 patients with type 1 diabetes underwent pancreas transplantation. There were 42 men and 30 women, with a mean age at transplantation of 38.1 +/- 7.5 years (range: 27 to 55 years), and a mean duration of diabetes of 22.5 +/- 6.6 years. Recipients were classified into two groups according to the preservation solution: (A) Celsior (n = 28, 38.9%) and (B) Wisconsin (n = 44, 61.1%). RESULTS: The donor and recipient characteristics were similar in both groups. There were five cases of venous thrombosis in the Wisconsin group and two in the Celsior group (P = NS). The venous drainage technique in the former group was portocaval in 19 patients and portoiliac in 25; in the Celsior group, portocaval in 23 patients and portoiliac in five (P = .001). Enteric drainage was used in 19 patients from the Celsior group and 17 patients from the Wisconsin group (P = .01). Actuarial 2-year graft survival was 74.6% in the Wisconsin group and 77.4% in the Celsior group (P = NS). CONCLUSIONS: No differences were observed in venous thrombosis between the two groups. The lower rate of venous thrombosis with the portocaval technique was related to the type of venous drainage rather than the type of preservation solution. Celsior solution may be considered as good as Wisconsin solution for pancreas transplantation.

Adenosine↗
PubMed1995

Extracellular and standard University of Wisconsin solutions provide equivalent preservation of myocardial function.

The deleterious effect of hyperkalemic cardioplegic solutions on coronary endothelium has been documented and has also been demonstrated with University of Wisconsin solution. We evaluated a new extracellular University of Wisconsin formulation for efficacy in heart preservation. Six neonatal piglet hearts were arrested with and stored in the standard intracellular University of Wisconsin solution (group 1: K+ 125 mEq/L, Na+ 29 mEq/L). Six piglet hearts were preserved for 24 hours with an extracellular University of Wisconsin solution that differed only in the concentrations of potassium and sodium (group 2: K+ 25 mEq/L, Na+ 129 mEq/L). Hearts underwent modified reperfusion with leukocyte-depleted aspartate-glutamate enriched blood cardioplegic solution followed by conversion to a left-sided working mode on a Langendorff circuit with perfusion from a support pig. Stroke work index was calculated at left ventricular end-diastolic pressures of 3, 6, 9, and 12 mm Hg. Sixty minutes after reperfusion, there was no significant difference in stroke work index between group 1 (16.4 +/- 1.9 x 1000 erg/gm) and group 2 (15.3 +/- 2.7 x 1000 erg/gm). There was also no significant difference in high-energy phosphate stores or myocardial water content between the two groups. Extracellular University of Wisconsin solution provides myocardial preservation equivalent to standard University of Wisconsin solution while preventing exposure of coronary endothelium to high levels of potassium, which justifies its use in clinical heart transplantation.

Adenosine↗
PubMed1999

Low-potassium University of Wisconsin solution for cardioplegia: improved protection of the isolated ischemic neonatal rabbit heart.

Recovery of cardiac function and high-energy phosphates following ischemia and reperfusion were determined for hearts perfused with low potassium University of Wisconsin solution, high potassium University of Wisconsin solution, St Thomas' solution, or subjected to hypothermia alone. Isolated hearts were arrested for either 3 h at 15 degrees C or 6 h at 20 degrees C (n = 7 for each group) with one of the four solutions and then reperfused. Aortic flow after ischemic arrest at 20 degrees C was 40.3 +/- 13.3%, 79.3 +/- 10.0%, 64.3 +/- 11.9% and 43.9 +/- 15.9% of control values for high potassium University of Wisconsin solution, low potassium University of Wisconsin solution, St Thomas' solution and hypothermia alone, respectively. Similar results were observed in hearts subjected to ischemic arrest at 15 degrees C. Myocardial adenosine triphosphate and creatine phosphate after reperfusion tended to be higher in the low potassium University of Wisconsin solution group. It is concluded that low potassium University of Wisconsin solution may provide reliable cardioplegia during surgery that requires prolonged cardiac arrest in neonates and infants.

Adenosine↗
PubMed1992

The effectiveness of University of Wisconsin solution on prolonged myocardial protection as assessed by phosphorus 31-nuclear magnetic resonance spectroscopy and functional recovery.

The effectiveness of the University of Wisconsin solution on extended myocardial preservation was examined in this study using phosphorus 31-nuclear magnetic resonance spectroscopy. Isolated perfused rat hearts were arrested and stored in four preservation solutions: group 1, modified Krebs-Henseleit solution; group 2, modified St. Thomas' Hospital solution; group 3, oxygenated modified St. Thomas' Hospital solution containing 11 mmol/L glucose; and group 4, University of Wisconsin solution. The changes in myocardial high energy phosphate profiles and the intracellular pH values were measured during 12 hours of cold (4 degrees C) global ischemia and 90 minutes of normothermic reperfusion. Following ischemia, the hearts were assessed for hemodynamic recovery and myocardial water content. During ischemia, adenosine triphosphate depletion was observed in all groups; however, after 5 hours of ischemia, the adenosine triphosphate levels were significantly higher in group 3 compared with the other groups (adenosine triphosphate levels at 6 hours in mumol/gm dry weight: group 3, 7.6; group 4, 3.2; group 2, < 1; p < 0.025). The tissue water content at the end of ischemia was lower with the University of Wisconsin solution compared with the modified St. Thomas' Hospital solution or the oxygenated modified St. Thomas' Hospital solution (in ml/gm dry weight: group 4, 3.0; group 2, 4.4; group 3, 3.9; p < 0.05). The adenosine triphosphate repletion during reperfusion was greater with the University of Wisconsin solution compared with the modified St. Thomas' Hospital solution or the oxygenated modified St. Thomas' Hospital solution (12 mumol/gm dry weight in group 4; 8.1 in group 2; 9.0 in group 3; p < 0.05). Similar findings were obtained for the recovery of left ventricular pressure (in percent of preischemic control: group 4, 70%; group 2, 42%; group 3, 52%; p < 0.01) and coronary flow (group 4, 61%; group 2, 49%; group 3, 49%; p < 0.05). These data suggest that preservation with the University of Wisconsin solution affords improved hemodynamic recovery, enhanced adenosine triphosphate repletion, and reduced tissue edema upon reperfusion; however, oxygenated St. Thomas' Hospital solution with glucose is associated with the preservation of higher myocardial adenosine triphosphate levels during prolonged cold global ischemia. In conclusion, these data indicate that the University of Wisconsin solution might improve graft tolerance of ischemia in clinical heart transplantation.

Adenosine↗
PubMed1992

Endothelial dysfunction caused by University of Wisconsin preservation solution in the rat heart. The importance of temperature.

The superiority of the University of Wisconsin solution over routinely used crystalloid cardioplegic solutions for myocardial preservation has been demonstrated in animal studies. We have investigated the effect of the University of Wisconsin solution at different temperatures on endothelial function by examining its influence on 5-hydroxytryptamine- and nitroglycerin-induced increase in coronary flow in the isolated rat heart. Thirty-eight rat hearts were perfused on a modified Langendorff preparation. In the control experiments, there was no significant difference in the percentage increase in coronary flow induced by 5-hydroxytryptamine and nitroglycerin after 30 minutes of perfusion with Krebs-Henseleit buffer (n = 6). Continuous infusion of the University of Wisconsin solution for 30 minutes at 4 degrees C or at 10 degrees C did not alter the 5-hydroxytryptamine or nitroglycerin response. However, infusion at 15 degrees C reduced the 5-hydroxytryptamine-induced vasodilation, while at 20 degrees C the 5-hydroxytryptamine response was converted to vasoconstriction without a significant change in nitroglycerin effect (15 degrees C, 5-hydroxytryptamine, before: 30.2% +/- 1.5%, after: 6.0% +/- 1.0%, nitroglycerin, before: 28.8% +/- 1.3%, after: 31.2% +/- 1.8%; 20 degrees C, 5-hydroxytryptamine, before: 32.2% +/- 2.5%, after: -23.8% +/- 3.6%, nitroglycerin, before: 30.3% +/- 1.9%, after: 33.5% +/- 1.7%). Coronary vascular resistance in the control experiments rose from 55.0 +/- 2.5 cm H2O/ml/gm/min to 58.4 +/- 2.3 cm H2O/ml/gm/min (p = not significant). The increase after University of Wisconsin solution infusion at 4 degrees C and at 10 degrees C was similarly not significant. Coronary vascular resistance increased significantly following infusion of University of Wisconsin solution at 15 degrees C (p < 0.001) or at 20 degrees C (p < 0.01). We conclude that University of Wisconsin solution produces temperature-dependent endothelial dysfunction in the isolated rat heart.

Adenosine↗
PubMed1992

Superiority of the University of Wisconsin solution over simple crystalloid for extended heart preservation. A study of left ventricular pressure-volume relationship.

To compare the effects of the University of Wisconsin solution with those of an extracellular crystalloid solution, Krebs-Ringer bicarbonate, as cardiac preservation media, we studied 35 adult dogs in an isolated heart preparation. Four groups of seven hearts were preserved in University of Wisconsin solution for 6 or 12 hours or in Krebs-Ringer bicarbonate solution for 6 or 12 hours. An additional group of seven hearts with no ischemia was used for a control group. In the four preservation groups, hearts were arrested by electrolyte solution (Normosol with potassium chloride, 20 mEq/L, added, 4 degrees C), flushed with 200 ml of the preservation solution, and then stored in the same solution at 1 degree to 2 degrees C. The hearts were mounted on an isolated heart preparation equipped with a computer-controlled servo-pump system that used a mock arterial system to modulate the aortic input impedance presented to the left ventricle. Left ventricular pressure-volume loops were measured on-line for 2 hours of reperfusion with autologous warm oxygenated blood. Elastance was derived from the end-systolic pressure-volume relationship, and diastolic compliance was derived from the end-diastolic pressure-volume relationship. The total left ventricular performance was assessed by the preload recruitable stroke work area, the slope, and its x-intercept, all of which derived from the stroke work (pressure-volume area)-end-diastolic volume relationship. Extended global ischemia had more deleterious effects on the end-diastolic than the end-systolic pressure-volume relationship. In confirmation with other studies, elastance did not accurately reflect the level of ventricular contractile dysfunction because of the significant amount of diastolic dysfunction. The preservation of myocardial systolic and diastolic functions, as demonstrated by the preload recruitable stroke work area and diastolic compliance, was better in the University of Wisconsin solution groups than in the Krebs-Ringer bicarbonate solution groups after 6 and 12 hours of preservation. In addition, 6 hours of preservation with University of Wisconsin solution maintained normal systolic and diastolic functions as compared with those of the control group. Preservation with University of Wisconsin solution prevented any myocardial edema formation; by contrast, this was significantly increased after 12 hours in Krebs-Ringer bicarbonate solution. Groups preserved with University of Wisconsin solution had less reperfusion injury as evidenced by the release of coronary sinus creatine kinase during reperfusion; they also had improved oxygen use during reperfusion.(ABSTRACT TRUNCATED AT 400 WORDS)

Adenosine↗
PubMed1991

Functional and morphological features of isolated hepatocytes preserved in University of Wisconsin solution.

Although several studies suggest that hepatic graft failure after cold ischemia results from nonparenchymal cell damage, other data indicate that hepatocellular ATP content is significantly correlated with the transplantation success rate. In this study, we have conducted a systematic investigation of various aspects of cell viability and function of isolated hepatocytes stored at 4 degrees C for 24 and 48 hr in either University of Wisconsin solution or Hanks' HEPES buffer, a control solution clinically unsuitable for organ preservation. After 24 hr, hepatocytes stored in Hanks' HEPES buffer had viability (measured by trypan blue exclusion and ALT and lactic dehydrogenase leakage), transport function (measured by 22Na+ and [3H]taurocholate uptake) and cell size similar or only slightly altered when compared with freshly isolated and University of Wisconsin solution-stored hepatocytes. ATP content was decreased in both groups; however, the reduction was much greater in Hanks' HEPES buffer-stored cells. Furthermore, ATP regenerating capacity was greatly reduced in Hanks' HEPES buffer- stored but not in University of Wisconsin solution-stored hepatocytes. By 48 hr viability and function of Hanks' HEPES buffer-stored hepatocytes were decreased; University of Wisconsin solution afforded partial protection. When examined by light and electron microscopy, cells stored in both University of Wisconsin solution and Hanks' HEPES buffer for 24 hr appeared essentially normal except for the presence of numerous membrane blebs in the Hanks' HEPES buffer group. Tissue sections of livers preserved in Hanks' HEPES buffer but not in University of Wisconsin solution revealed the presence of extensive amounts of blebs in the sinusoidal lumen and loss of endothelial elements.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenosine↗
PubMedDate not supplied

University of Wisconsin solution provides superior myocardial preservation compared with Stanford cardioplegic solution.

The efficacy of the University of Wisconsin solution to safely prolong preservation times for kidney, pancreas, and liver transplantation is established, but its efficacy in enhancing myocardial preservation is not yet clear. We studied the effects of Stanford cardioplegic solution and the University of Wisconsin solution both in preserving the myocardium and in protecting it from the effects of reperfusion injury after 6 hours of preservation. In 28 rat hearts we measured changes in high-energy phosphate content (with magnetic resonance spectroscopy) and histologic changes (edema, endothelial changes, myocyte architecture) during preservation and changes in high-energy phosphate content, histologic status, and performance (aortic systolic and diastolic pressure, heart rate, rhythm) in Langendorff and working hearts during reperfusion. No significant differences in the kinetics of high-energy phosphate changes were noted between the two cardioplegic solutions during preservation. However, at the end of 6 hours of preservation, hearts in the Stanford cardioplegic solution group were more edematous (p < 0.01) than those in the University of Wisconsin group. During reperfusion, no significant differences in the kinetics of high-energy phosphates were noted between the two cardioplegic solutions. None of the hearts in the University of Wisconsin solution group developed ventricular fibrillation at the start of reperfusion, but all hearts in the Stanford group did so. Once sinus rhythm was established no significant differences in developed pressure or heart rate were found between the two solutions. After 2.5 hours of reperfusion, hearts in the Stanford group were more edematous (p < 0.002) and had a greater disruption of myocyte architecture (p < 0.002) and greater arteriolar endothelial injury (p < 0.004). In conclusion, the University of Wisconsin solution better protects the myocardium in this rat model than does Stanford solution. The mechanism for this beneficial effect of the University of Wisconsin solution appears to be due to its better preservation of the microvasculature rather than differences in preservation of high-energy phosphates.

Adenosine↗
PubMedDate not supplied

Evaluation of hypothermic heart preservation with University of Wisconsin solution in heterotopically and orthotopically transplanted canine hearts.

In simple cold storage of the heart, 4 hours has been proved to be a clinically safe ischemic time. The University of Wisconsin solution has been reported to extend cold ischemic time in preservation of the liver, kidney, and pancreas. The purpose of this study is to clarify the safe cold ischemic time in heart preservation with University of Wisconsin solution experimentally in heterotopically and orthotopically transplanted canine hearts. In heterotopic heart transplantation, 120 minutes after reperfusion, maximum slope of the left ventricular end-systolic pressure-volume relationship was recovered to 94% +/- 13% in the 4-hour simple cold preservation group with GIK solution and 104% +/- 11% in the 8-hour simple cold preservation group with University of Wisconsin solution but was not recovered in the 8-hour simple cold preservation with GIK solution and 16-hour simple cold preservation with University of Wisconsin solution groups. One hundred twenty minutes after reperfusion, myocardial tissue blood flow measured by laser Doppler flowmeter was recovered to 90% +/- 19% after 4 hours with simple cold preservation with GIK solution and 98% +/- 9% after 8 hours with simple cold preservation with University of Wisconsin solution but was not recovered after 8 hours with simple cold preservation with GIK solution and 16 hours with simple cold preservation with University of Wisconsin solution.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenosine↗
PubMed1994

Prolonging myocardial preservation with a modified University of Wisconsin solution containing 2,3-butanedione monoxime and calcium.

The University of Wisconsin solution is an effective preservative for cold storage of the cardiac allograft. In an earlier study we showed that addition of calcium and 2,3-butanedione monoxime, a reversible inhibitor of myocardial contracture, further improved preservation of the rabbit heart. In this study we investigated the following: (1) the effects of different concentrations of 2,3-butanedione monoxime and calcium on function of the preserved rabbit heart, (2) how heart preservation is affected when 2,3-butanedione monoxime and calcium are added to the St. Thomas' Hospital and Stanford solutions, and (3) how 2,3-butanedione monoxime and calcium, at optimal concentrations in University of Wisconsin solution, affect hearts preserved up to 48 hours. Rabbit hearts were flushed with preservative and stored at 4 degrees C for 24, 30, 40, or 48 hours. Myocardial function was assessed during 60 minutes of isolated reperfusion, and myocardial adenine nucleotide content was measured after completion of reperfusion. Three concentrations of 2,3-butanedione monoxime (15, 30, and 60 mmol/L) in the University of Wisconsin solution were studied in hearts preserved for 30 hours. Storage with 2,3-butanedione monoxime at 30 mmol/L resulted in significantly better left ventricular developed pressure (p < 0.01), left ventricular end-diastolic volume (p < 0.01), rate of left ventricular pressure rise (p < 0.01), coronary flow (p < 0.05), rate-pressure product (p < 0.001), and adenine nucleotide regeneration (p < 0.05) than with 60 mmol/L, although function was not significantly different when the osmolarity of the solutions was equalized. There was significant reduction in end-diastolic volume (p < 0.05) and adenine nucleotide recovery (p < 0.01) when 2,3-butanedione monoxime was lowered to 15 mmol/L. Decreasing the calcium concentration from 1.0 to 0.1 mmol/L also had a deleterious effect on myocardial function (p < 0.05). The addition of 30 mmol/L 2,3-butanedione monoxime and 1.0 mmol/L calcium to the St. Thomas' or Stanford solutions improved preservation of the heart when compared with the unmodified solutions, but to a lesser degree than with the modified University of Wisconsin solution. After 24 to 48 hours of storage in University of Wisconsin solution containing 30 mmol/L 2,3-butanedione monoxime and 1.0 mmol/L calcium, there was substantial improvement in developed pressure (p < 0.001), end-diastolic volume (p < 0.05), and rate pressure product (p < 0.001), although there was little effect on heart rate and coronary flow, when compared with the unmodified University of Wisconsin solution.(ABSTRACT TRUNCATED AT 400 WORDS)

Adenosine↗
PubMed1994

Loss of endothelium-dependent vasodilatation and nitric oxide release after myocardial protection with University of Wisconsin solution.

University of Wisconsin solution has proved to be a superior form of cardioplegia for cardiac transplantation, demonstrating better functional recovery than that provided by extracellular crystalloid solutions. Furthermore, experimental data have suggested a role for University of Wisconsin solution in protection of the neonatal heart during operations for congenital heart defects. However, significant concerns have been raised regarding potential endothelial injury from the high potassium concentration contained in University of Wisconsin solution that could affect its safety and thus its clinical application. Fourteen neonatal (aged 1 to 3 days) piglet hearts were harvested and supported on an isolated, blood-perfused circuit. Endothelium-dependent vasodilatation was measured by bradykinin (10(-6) mol/L) infusion and nitric oxide release was determined. Endothelium-independent vasodilatation was then induced by sodium nitroprusside (10(-6) mol/L) infusion. A 2-hour period of cold cardioplegic arrest was instituted with multidose University of Wisconsin solution (group 1, n = 7) or blood cardioplegia (group 2, n = 7). After reperfusion and stabilization, another stimulation with bradykinin and nitroprusside was carried out and nitric oxide was again measured. After 2 hours of arrest with University of Wisconsin solution, there was a near-complete loss of vasodilatation in response to bradykinin infusion; coronary blood flow reached 245% of baseline before arrest versus only 117% of baseline after arrest (p = 0.0011). This correlated with an inability of the endothelium to release nitric oxide (96 +/- 30 nmol/min before arrest versus -32 +/- 9 nmol/min after arrest, p = 0.0039. In group 2, the vasodilatory response to bradykinin was preserved after arrest and reperfusion; 265% of baseline before arrest versus 222% of baseline after arrest. These results demonstrate a loss of endothelium-dependent vasodilatation after multidose University of Wisconsin cardioplegia caused by the inability of the endothelium to release nitric oxide. In contrast, blood cardioplegia does not result in impaired endothelial function.

Adenosine↗
PubMedDate not supplied

One-hour exposure to University of Wisconsin solution does not impair endothelium-dependent relaxation or damage vascular smooth muscle of epicardial coronary arteries.

To determine whether University of Wisconsin solution impairs production of endothelium-derived relaxing factor or damages vascular smooth muscle function of epicardial coronary arteries, isolated segments of canine left circumflex coronary artery were exposed to either cold (7 degrees C) or normothermic (37 degrees C) University of Wisconsin solution or to cold (30 degrees C) or normothermic (37 degrees C) physiologic salt solution in vitro for 60 minutes. After incubation with the solutions, the vascular segments were studied in vitro in organ chambers. Exposure to cold or to normothermic University of Wisconsin solution did not alter endothelium-dependent relaxation (either maximal relaxation or ED50) of the segments in response to adenosine diphosphate or acetylcholine (10(-9) to 10(-4) mol/L). Also, contraction of the segments in response to potassium ions (voltage-dependent) or prostaglandin F2 alpha (receptor-dependent) and relaxation in response to isoproterenol (cyclic AMP-mediated) or sodium nitroprusside (cyclic GMP-mediated) were unaltered after exposure to cold University of Wisconsin solution. Direct exposure to normothermic University of Wisconsin solution induced transient vasoconstriction in segments with or without endothelium. Thus University of Wisconsin solution does not irreversibly impair release of endothelium-derived relaxing factor or alter function of vascular smooth muscle in epicardial coronary arteries.

Adenosine↗
PubMed2003

A palliative care needs assessment of health care institutions in Wisconsin.

BACKGROUND: In 1999 the Wisconsin Coalition to Improve Palliative Care (WCIPC) conducted a palliative care needs assessment of health care institutions throughout the state of Wisconsin to document the current status of palliative care and identify institutional barriers and opportunities for improvement. METHOD: A survey instrument was developed to assess provisions of palliative care in the following areas: services currently provided, staff education programs offered in the previous year, barriers to the delivery of palliative care, and resources that would be useful to the participating institutions. Surveys were mailed to 881 health care institutions in Wisconsin; 318 (36%) surveys were returned. RESULTS: The three most common end-of-life care services present included a program to promote advance care planning, a contractual relationship with one or more hospice programs, and an interdisciplinary care program for dying patients. Pain management and advance directives were the two most common topics of educational programs offered in the past year. The most frequently cited barriers to good end-of-life care included a lack of knowledge among patients/families, a lack of provider knowledge about pain and symptom control, and poor reimbursement for end-of-life care. Resources that institutions felt would be useful included newsletters, a speaker's bureau, and information about establishing quality improvement programs for palliative care. CONCLUSIONS: While health care institutions in Wisconsin provide a variety of palliative care services and offer educational programs that address areas of palliative care, institutional barriers do exist. This needs assessment provides valuable descriptive data that will guide efforts to improve palliative care throughout the state of Wisconsin.

Health Facilities↗
PubMed2001

Organochlorine contaminants and biomarker response in double-crested cormorants nesting in Green Bay and Lake Michigan, Wisconsin, USA.

Double-crested cormorant (Phalacrocorax auritus) eggs at pipping and sibling 10-day-old chicks were collected from two colonies in Green Bay, WI, one colony in Lake Michigan, WI, and reference colonies in South Dakota and Minnesota. Egg contents and chicks were analyzed for organochlorine contaminants including polychlorinated biphenyl (PCB) congeners. Livers of embryos and chicks were assayed for hepatic microsomal ethoxyresorufin-O-dealkylase (EROD) activity. Eggshell thickness and the physical dimensions of embryo brains were measured. Concentrations of organochlorines, including p,p'-DDE (p,p'-dichlorodiphenyldichloroethylene), PCBs, and PCB congeners were generally an order of magnitude higher in eggs and chicks from Wisconsin than from reference locations. Total PCBs averaged 10-13 microg/g wet weight in eggs from three Wisconsin colonies compared to 0.9 microg/g PCBs from reference locations. Double-crested cormorant chicks accumulated on average 33-66 microg PCBs/day and 7-12 microg p,p'-DDE/day in the Wisconsin colonies compared to 0 microg PCBs/day and 1 microg p,p'-DDE/day in the reference colonies. At pipping, EROD activity in the livers of cormorant embryos was significantly higher in the Wisconsin colonies and significantly correlated with PCBs and the toxic equivalents (TEQs) of aryl hydrocarbon-active PCB congeners relative to 2,3,7,8-tetrachlorodibenzo-p-dioxin. However, in 10-day-old chicks EROD activity was not consistently different among colonies and was not correlated with PCBs or TEQs. A significant negative relationship between embryo brain asymmetry and the size of the egg suggested that physical constraint might be an important factor influencing the response of this bioindicator. Thinner eggshells in two colonies located near Door County, Wisconsin, suggested that historic p,p'-DDE residues associated with orchards are still an important source of p,p'-DDE in the local environment.

Abnormalities, Drug-Induced↗
PubMed2006

Risk of breast cancer for women living in rural areas from adult exposure to atrazine from well water in Wisconsin.

Research has suggested possible human health effects from low-level widespread exposure to environmental contaminants. We employed a novel exposure estimation technique using a publicly available data set to examine atrazine exposure, a suspected endocrine disruptor, in relation to breast cancer risk for women living in rural areas of Wisconsin. Incident breast cancer cases who were 20-79 years of age from 1987 to 2000 (n=3,275) and living in rural areas of Wisconsin at the time of interview were identified from Wisconsin's statewide cancer registry. Female controls of similar age and living in rural areas of Wisconsin were randomly selected from population lists (n=3,669). The addresses at diagnosis or reference year of study participants were assigned latitude/longitude coordinates (geocoded). The results from three statewide random studies of atrazine levels in well water in 1994, 1996, and 2001 were obtained from the Wisconsin Department of Agriculture, Trade, and Consumer Protection. Natural neighbor interpolation was used to estimate atrazine exposure levels separately for each of the 3 years. The mean atrazine exposure level was assigned to each participant based on her geocode. After adjustment for established breast cancer risk factors, compared to women in the lowest category of atrazine exposure (<0.15 ppb), the odds ratio of breast cancer for women exposed to atrazine concentrations of 1.0-2.9 ppb was 1.1 (95% CI 0.9-1.4). Results from this large population-based study do not suggest an increased risk of breast cancer from adult exposure to atrazine in drinking water. The possible risk for women exposed to levels of atrazine at or above statutory action levels of >or=3 ppb (OR 1.3, 95% CI 0.3-6.5) could not be ruled out due to small numbers in this category.

Adult↗