Preventing fat embolism syndrome (FES) in implantation of cemented hip endoprosthesis shafts with a trans-prosthetic drainage system (TDS)]

In vitro studies with the transprosthetic drainage system (TDS) have revealed a reduction in intrafemoral pressure in cemented total hip prosthesis. The aim of the present study was to establish whether the incidence of fat embolic syndrome (FES) is also reduced. Ten patients underwent standardized cemented total hip replacement using TDS under standardized general anaesthesia. The usual peri-operative monitoring measures were extended to include cardiopulmonary monitoring (pulmonary artery catheter, intra-arterial blood pressure) and two-dimensional transoesophageal echocardiography. Previous studies had reported an increased risk for fat embolic syndrome with conventional, and even with vacuum cementing techniques. Our recorded cardiopulmonary data and the data provided by two-dimensional transoesophageal echocardiography show a significant reduction in pulmonary embolism with TDS. This technique can be recommended in particular for high-risk patients (osteoporosis, elderly patients) and the implantation of long femoral stems. On the basis of the clinical data, a new femoral stem allowing the use of the TDS technique is being developed.     

Dynamics of human milk extraction: A comparative study of breast feeding and breast pumping

We describe a mathematical model of the flow and deformation in a human teat. Our aim is to compare the theoretical milk yield during infant breast feeding with that obtained through the use of a breast pump. Infants use a peristaltic motion of the tongue, along with some suction, to extract milk, whereas breast pumps use a cyclic pattern of suction only. Our model is based on quasi-linear poroelasticity whereby the teat is modelled as a cylindrical porous elastic material saturated with fluid. We impose a cyclic axial suction pressure difference across the teat and impose a radial compressive force moving along the teat which mimics infant suckling. This is compared to the case of cyclic and steady pumping only which models the action of breast pumps. The results illustrate that there is an optimal time to apply the compressive force during the suction cycle that will increase the flow rate in our theoretical teat. The model and results may be of use in the future design of effective breast pumps.     

The use of bacteriophage as tracers of aerosols liberated by sludge suction appliances

Three bacteriophage tracers were added to 600-1 containers of water and simulated latrine sludge to provide high titres of tracer in aqueous and semi-aqueous media. After a period of mixing and stabilization, media were removed from the containers with suction hoses coupled to the vacuum pump of one of two sludge suction tankers. Exhaust air from the appliances was sampled by cyclone sampler and assayed for the presence of tracer organisms carried over during the emptying process. In the experiments the appliances were operated at different vacuum pump speeds, drawing both aqueous and semi-aqueous (simulated sludge) media. Air around one tanker was also sampled during the emptying, under pressure, of the vacuum vessel. The degree of aerosolization and expulsion of tracer bacteriophage by the vacuum appliances was consistently low, regardless of medium and pump air flow. In contrast, the proportion of tracer retained within the appliances was very high, exceeding the proportion expelled by a minimum of 8 log10 orders of magnitude and a maximum of greater than 11 log10 orders. The highest total of tracer bacteriophage was recovered during the pressure emptying of the vacuum vessel of one tanker. The results may be used for assessing and comparing potential public health hazards associated with the handling of wastewater sludge by vacuum appliances.     

The use of bacteriophage as tracers of aerosols liberated by sludge suction appliances

Three bacteriophage tracers were added to 600–1 containers of water and simulated latrine sludge to provide high titres of tracer in aqueous and semi-aqueous media. After a period of mixing and stabilization, media were removed from the containers with suction hoses coupled to the vacuum pump of one of two sludge suction tankers. Exhaust air from the appliances was sampled by cyclone sampler and assayed for the presence of tracer organisms carried over during the emptying process. In the experiments the appliances were operated at different vacuum pump speeds, drawing both aqueous and semi-aqueous (simulated sludge) media. Air around one tanker was also sampled during the emptying, under pressure, of the vacuum vessel. The degree of aerosolization and expulsion of tracer bacteriophage by the vacuum appliances was consistently low, regardless of medium and pump air flow. In contrast, the proportion of tracer retained within the appliances was very high, exceeding the proportion expelled by a minimum of 8log₁₀ orders of magnitude and a maximum of greater than 11log₁₀ orders. The highest total of tracer bacteriophage was recovered during the pressure emptying of the vacuum vessel of one tanker. The results may be used for assessing and comparing potential public health hazards associated with the handling of wastewater sludge by vacuum appliances.     

The Evolution of Lung-Gill Bimodal Breathing and the Homology of Vertebrate Respiratory Pumps

SYNOPSIS. A comparative analysis of actinopterygian and sarcopterygianaerial buccal pumps indicates that the primitive pattern ofair transfer differs fundamentally between these two clades.Actinopterygian fishes ventilate their lungs with a four-strokebuccal pump: the buccal cavity expands and fills with expiredair, compresses to expel expired air, expands again to takein fresh air, and then compresses again to pump fresh air intothe lungs. Lungfishes, caudates, and anurans expand and compressthe buccal cavity only once per expiratory-inspiratory cycle,and thus use a two-stroke pump. Both of these bidirectional,aerial buccal pumps evolved from unidirectional, aquatic buccalpumps. The two-stroke aerial pump and the primitive aquaticpump used for gill irrigation share slow movements and may bothbe triggered by the same central rhythm generator. These similaritiessuggest that the two-stroke buccal pump evolved from the gillirrigation pump. Similarly, the four-stroke pump shares rapidmovement and afferent triggering with aquatic suction feedingand coughing, suggesting that the four-stroke pump may haveevolved from a combination of two suction feeding or coughingmovements. Thus the differences between the actinopterygianand sarcopterygian aerial buccal pumps may be due to their independentevolution from different aquatic buccal pumps, rather than dueto divergence from a single aerial buccal pump.     

Vacuum-assisted perfusion of the dog hindlimb

A method for rapidly changing perfusion pressure to the relatively intact dog hindlimb using vacuum assistance is proposed and demonstrated. The hindlimb of an anesthetized dog is inserted into a rigid sealed enclosure for application of a partial vacuum. The circulation of the hindlimb remains entirely intact except for a single large noncollapsible catheter placed in the femoral vein and connected to a servo-pump. The servo-pump maintains the venous pressure equal to the enclosure pressure even when this pressure is in the partial vacuum state. The automatically adjusted pumping rate of this pump also provides a continuous measure of the blood flow in the limb as it returns the blood via a jugular catheter. In nine dogs the systemic arterial pressure was maintained constant, and the enclosure pressure and venous pressure were set to subatmospheric levels, thus changing the perfusion pressure to any desired value up to 220 mmHg. The procedure had minimal impact on the central circulation, suggesting that the technique may be useful in studying hemodynamics of the hindlimb or other organs at high perfusion pressure, which has always been difficult to achieve experimentally. In the nine dogs, blood flow responses were observed at both elevated and reduced perfusion pressure. The changes in measured blood flow induced by the changes in perfusion pressure were variable but were generally directly proportional to perfusion pressure in the steady state.     

Possibilities of avoiding an intra-femoral increase in pressure during hip revision surgery]

An earlier experimental study carried out by us revealed an increase in intrafemoral pressure during removal of cement in hip revision arthroplasty. This increase is greater while removing cement from the distal femoral shaft. Maximum pressure increases occurred while removing the medullary plug (cement stopper), and the measured pressure of more than 150 mmHg is associated with an increased risk of fat embolism. The present study shows that this phenomenon can be avoided through the use of cannulated instruments.     

Numerical simulation and comparative analysis of flow field in axial blood pumps

The objective study was to estimate the rheological properties and physiological compatibility of the blood pump by simulating the internal flow field of the blood pump. In this study we use computational fluid dynamics method to simulate and analyse two models of axial blood pumps with a three-blade diffuser and a six-blade diffuser, named pump I and pump II, respectively, and to compare the flow patterns of these two kinds of blood pumps while both of them satisfy the conditions of the normal human blood differential pressure and blood flow. Results indicate that (i) the high shear force occurs between the diffuser and the rotor in which the crucial place leads to haemolysis and (ii) under the condition of 100 mmHg pressure head and 5 l/min flow rate, the difference between the two kinds of blood pumps, as far as the haemolytic performance is concerned, is notable. The haemolysis index of the two pumps is 0.32% and 0.2%. In conclusion, the performance of the blood pump is influenced by the diffusers' blade number. Pump II performed better than pump I, which can be the basic model for blood pump option.     

Succinic dehydrogenase activity of the respiratory muscles of a fresh-water teleost, Bagarius bagarius (Ham.) (Sisoridae, Pisces).

Functional morphology including the origin, insertion, and innervation of the respiratory muscles in relation to buccal pressure pump and opercular suction pumps in a fresh-water bottom dwelling siluroid fish, Bagarius bagarius have been studied. Histochemical studies were made on the succinic dehydrogenase activity of adductor mandibulae, retractor tentaculi, levator operculi, dilatator operculi, adductor operculi, intermandibularis, interhyoideus, hyohyoideus superior and constrictor branchialis. The intensity of reaction reveals the presence of three types of muscle fibres in some of the respiratory muscles. The muscle containing red muscle fibres are mostly innervated by the branches of the VIIth cranial nerve. The retractor tentaculi consists of superficial white muscle fibres and the interior part is dominated by red muscle fibres. The muscles (adductor operculi, levator operculi, dilatator operculi, interhyoideus, hyohyoideus superior) concerned with the opercular suction pumps are of mixed type and consist of white and red muscle fibres, whereas adductor mandibulae and intermandibularis are made up entirely of white muscle fibres. The adductor muscle bundles of the constrictor branchialis, which are responsible for movement of gill filaments, are dominated by the red muscle fibres. The abductor part, however, is made up entirely of white muscle fibres.     

A simple pressure filtration apparatus for field use

A simple apparatus for pressure-filtering water samples in the field is described. It is used in conjunction with the low pressure outlet of a standard regulator attached to an aqualung. The apparatus is useful in situations where electricity to run electric vacuum pumps is not available and is superior to conventional hand vacuum pumps.     

Regional fat aspiration for body contouring

Our experience with the original suction lipectomy is presented. The fat removal, done with a specially designed suction tube, is performed layerwise, creating a continuous, regular cavity that is transformed into a virtual space by compressive dressings. The main indication being excessive peritrochanteric fat pads, the operation is done under either epidural or general anesthesia. No antibiotics or anticoagulants are administered, and the patients are mobilized as soon as fully awake. Practicing suction-assisted lipectomy for more than seven years, we have never observed an infection, thrombosis, or fat embolism. In experienced hands, good results can be expected in about 80 percent of patients. Complications are almost always of an aesthetic nature as a result of bad indications. The method is not a surgical treatment for severe obesity.     

Regulation of plant elongation growth by surface and xylem proton pumps

The roles of plasmalemma electrogenic proton pumps in elongation growth of plant stems are discussed on the basis of growth-electrophysiological studies on hypocotyl segments ofVigna unguiculata. Plant stems usually have two spatially separated electrogenic proton pumps: the surface proton pump which is located on the surface membrane of the symplast and the xylem proton pump, on the cell membrane of the symplast/xylem apoplast boundary. The surface proton pump excretes protons into the surface cell wall layer and causes the loosening of the cell wall. The xylem proton pump excretes protons into the xylem apoplast and drives the uptake of solute and water into the symplastvia secondary and/or tertiary active mechanisms: the proton cotransport system and the apoplast canal system. Both the surface and the xylem proton pumps are active during elongation growth because both the yielding of cell wall loosening and the uptake of water are necessary for continued elongation growth.     

Adhesion and Suction Functions of the Tip Region of a Nectar-drinking Butterfly Proboscis

In this study,we investigated the dynamic functions of the tip region of the butterfly proboscis through which liquid is sucked during liquid feeding.The microstructures and flow patterns in the tip region of the proboscis were in vivo analyzed.The tip region can be divided into two functional sections:namely adhesion and suction sections.The liquid adheres to the adhesion section during liquid suction.Although the tip region has numerous slits connected to food canal of the proboscis,liquid is mainly sucked through the suction section,which section is submerged in the fluid pulled by the adhesion section and then successfully imbibes liquid.To check the dynamic functions of the tip region,we fabricated a suction tip model having adhesion and suction parts.The in vitro model experiments show that the hydrophilicity of the adhesion part and the existence of the suction inlet improve the liquid uptake driven by a suction pump.This study may provide insights for the biomimetic design of nectar-feeding butterflies.     

En bloc cervical lipectomy for treatment of the problem neck in facial rejuvenation surgery

The treatment of cervical fat in facial aesthetic surgery has received much attention in recent years. Suction lipectomy has become a very popular technique for removing cervical fat because it is easy to perform and results in few complications. This paper describes the en bloc excision of cervical fat in conjunction with rhytidectomy. The senior author has treated 1,000 patients over 17 years using this technique with a high degree of patient satisfaction and minimal morbidity. Although suction lipectomy alone may be indicated for the younger patient, our experience suggests that the en bloc excisional technique is the treatment of choice in the older patient in whom a rhytidectomy is also indicated. In contrast with suction lipectomy, we have found that the en bloc excision of cervical fat allows for more anatomic dissection and facilitates removal of greater amounts of fat and better redraping of the cervical skin.     

Flow limitation and wheezes in a constant flow and volume lung preparation

To facilitate the study of respiratory wheezes in an animal lung model, an isovolume, constant-flow excised dog lung preparation was developed. Dog lungs were inflated to 26 +/- 4 cmH2O and coated with layers of epoxy glue and polyester compound. A rigid shell 2 mm thick was obtained around the entire pleural surface and the extra-pulmonary airways. The adhesive forces between the pleura and the shell were strong enough to hold the lung distended after the inflation pressure was removed. Holes 2 mm diam were drilled through the shell over one of the lung lobes in an array, 4 cm across. The holes penetrated the pleural surface, so that constant flow could be maintained in the expiratory direction by activating a suction pump connected to the trachea. Downstream suction pressure and flow rate were measured with a mercury manometer and a rotameter, respectively. Sounds were recorded by a small (0.6 cm OD) microphone inserted into the trachea. When suction pressure was increased, flow initially increased to 31 +/- 3 l/min. Further increase of suction pressure caused only very slight additional increase in flow (i.e., flow limitation). During this plateau of flow, a pure tone was generated with acoustic properties similar to respiratory wheezes. Both the flow plateau and the wheezing sounds could be eliminated by freezing the lungs. It is concluded that wheezing sounds were associated with flow limitation in this preparation. It is suggested that the stable acoustic properties obtained by this preparation may become useful in the analysis of mechanisms of wheezing lung sounds generation.     

Functional roles for the compartmentalization of the subcutaneous lymphatic sacs in anuran amphibians

Compliance of the subcutaneous lymph sacs of the hindlimbs increases from distal to proximal, as does limb segment mass (and presumably rate of lymph formation), for the semiaquatic bullfrog Rana catesbeiana and the cane toad Bufo marinus but not the aquatic clawed toad Xenopus laevis. Subcutaneous lymph-sac compliances vary interspecifically. The distal-to-proximal increase in lymph-sac compliance and estimates of lymph formation rate in the various hindlimb segments indicate that partitioning of hindlimb subcutaneous lymphatic sacs establishes a differential decrease in the intra-lymph-sac pressure for R. catesbeiana and B. marinus. These pressure differentials constitute a "compliance pump" that drives distal-to-proximal intersac lymph flow. The compliance pump alone explains lymphatic return for the aquatic frog X. laevis but does not explain how lymph would reach the dorsally located lymph hearts for terrestrial anurans, so we hypothesize that skeletal muscle pumps return lymph from the femoral and pubic lymph sacs to the lymph heart. This is a fundamentally different role of the subcutaneous lymph-sac system than has been previously proposed. We suggest that the more proximal subcutaneous lymph sacs are important for fluid storage because they have a relatively high compliance.     

A vacuum benthos sampler suitable for diverse habitats

The vacuum benthos sampler consists of a vacuum chamber equipped with a collecting net connected to the intake of a 12 volt pump, a battery, and a standpipe. Contents of the standpipe are vacuumed while substrate is removed and washed with the exhaust hose. The vacuum chamber is designed for rapid changing of nets during replicate sampling. This sampler is equally efficient in flowing and standing water. It was more effective than a modified Hess sampler for collecting a large variety of benthos from flowing (ca 0.25–0.75 m/s) riffles. Required operation time is variable, but 93% of invertebrates caught in 10 min were captured in the first 5 min during our tests, and there was a 94% mean recovery of released organisms during 10 min of subsequent operation. Advantages over previous suction samplers include interception of organisms before they pass through a pump, return of outlet water to the standpipe, capability of sampling in shallow (20–30 mm) water, and that it can be carried and operated by one person.     

Endoscopy in cattle by the paralumbar route: Technique for ovarian examination and follicular aspiration

The ovary and follicular aspiration, or both, were observed in 50 heifers by endoscopy via the right paralumbar fossa. A total of 129 laparoscopies were performed. Eight animals underwent more than four interventions. Occasionally adhesions were observed, but they never interfered with ovary examination and follicular aspiration. The rate of ovum recovery was higher when a suction device was used rather than a syringe system (P < 0.01). The bore size of the needles influenced the proportion of oocytes obtained from the follicular aspirates. The use of a 19-G (1.00 mm) needle with a 45-degree bevel and a vacuum pressure of 250 mmHg gave the best results (recovery rate: 72%). This was significantly higher (P < 0.01) than the results obtained with a 21-G needle and a vacuum pressure of 500 mmHg (recovery rate: 53%).     

One proboscis,two tasks: Adaptations to blood-feeding and nectar-extracting in long-proboscid horse flies (Tabanidae,Philoliche)

Female Pangoniinae in the tabanid fly genus Philoliche can display remarkably elongated proboscis lengths, which are adapted for both blood- and nectar-feeding. Apart from their role as blood-sucking pests, they represent important pollinators of the South African flora. This study examines the morphology of the feeding apparatus of two species of long-proboscid Tabanidae: Philoliche rostrata and Philoliche gulosa – both species display adaptations for feeding from a diverse guild of long-tubed flowers, and on vertebrate blood. The heavily sclerotised proboscis can be divided into two functional units. The short, proximal piercing part is composed of the labrum-epipharynx unit, the hypopharynx and paired mandible and maxilla. The foldable distal part is composed of the prementum of the labium which solely forms the food canal and is responsible for nectar uptake via the apical labella. The proboscis works as a drinking straw, relying on a pressure gradient provided by a two-part suction pump in the head. Both proboscis and body lengths and suction pump dimensions show a significantly correlated allometric relationship with each other. This study provides detailed insights into the adaptations for a dual diet using an elongated sucking proboscis, and considers these adaptations in the context of the evolution of nectar feeding in Brachycera.     

Two functionally different Na/K pumps in cardiac ventricular myocytes

The whole-cell patch-clamp technique was used to voltage clamp acutely isolated myocytes at -60 mV and study effects of ionic environment on Na/K pump activity. In quiescent guinea pig myocytes, normal intracellular Na+ is approximately 6 mM, which gives a total pump current of 0.25 +/- 0.09 pA/pF, and an inward background sodium current of 0.75 +/- 0.26 pA/pF. The average capacitance of a cell is 189 +/- 61 pF. Our main conclusion is the total Na/K pump current comprises currents from two different types of pumps, whose functional responses to the extracellular environment are different. Pump current was reversibly blocked with two affinities by extracellular dihydro-ouabain (DHO). We determined dissociation constants of 72 microM for low affinity (type-1) pumps and 0.75 microM for high affinity (type-h) pumps. These dissociation constants did not detectably change with two intracellular Na+ concentrations, one saturating and one near half- saturating, and with two extracellular K+ concentrations of 4.6 and 1.0 mM. Ion effects on type-h pumps were therefore measured using 5 microM DHO and on total pump current using 1 mM DHO. Extracellular K+ half- maximally activated the type-h pumps at 0.4 mM and the type-1 at 3.7 mM. Extracellular H+ blocked the type-1 pumps with half-maximal blockade at a pH of 7.71 whereas the type-h pumps were insensitive to extracellular pH. Both types of pumps responded similarly to changes in intracellular-Na+, with 9.6 mM causing half-maximal activation. Neither changes in intracellular pH between 6.0 and 7.2, nor concentrations of intracellular K+ of 140 mM or below, had any effect on either type of pump. The lack of any effect of intracellular K+ suggests the dissociation constants are in the molar range so this step in the pump cycle is not rate limiting under normal physiological conditions. Changes in intracellular-Na+ did not affect the half-maximal activation by extracellular K+, and vice versa. We found DHO-blockade of Na/K pump current in canine ventricular myocytes also occurred with two affinities, which are very similar to those from guinea pig myocytes or rat ventricular myocytes. In contrast, isolated canine Purkinje myocytes have predominantly the type-h pumps, insofar as DHO-blockade and extracellular K+ activation are much closer to our type-h results than type-1. These observations suggest for mammalian ventricular myocytes: (a) the presence of two types of Na/K pumps may be a general property. (b) Normal physiological variations in extracellular pH and K+ are important determinants of Na/K pump current. (c) Normal physiological variations in the intracellular environment affect Na/K pump current primarily via the Na+ concentration. Lastly, Na/K pump current appears to be specifically tailored for a tissue by expression of a mix of functionally different types of pumps.