Sesquiterpene lactones from Centaurea tweediei.

Aerial parts of Centaurea tweediei from Argentina afforded as the main constituent the sesquiterpene lactone onopordopicrin and minor amounts of a new heliangolide, a new guaianolide, a new eudesmanolide, a new eudesmane acid and the lignans arctigenin and matairesinol.

Numerically based design of an orifice plate flowmetering system for human respiratory flow monitoring.

During certain medical procedures, it is important to continuously measure the respiratory flow of a patient, as lack of proper ventilation can cause brain damage and ultimately death. The monitoring of the ventilatory condition of a patient is usually performed with the aid of flowmeters. However, water and other secretions present in the expired air can build up and ultimately block a traditional, restriction-based flowmeter; by using an orifice plate flowmeter, such blockages are minimized. This paper describes the design of an orifice plate flowmetering system including, especially, a description of the numerical and computational techniques adopted in order to simulate human respiratory and sinusoidal air flow across various possible designs for the orifice plate flowmeter device. Parallel computation and multigrid techniques were employed in order to reduce execution time. The simulated orifice plate was later built and tested under unsteady sinusoidal flows. Experimental tests show reasonable agreement with the numerical simulation, thereby reinforcing the general hypothesis that computational exploration of the design space is sufficiently accurate to allow designers of such systems to use this in preference to the more traditional, mechanical prototyping techniques.

[Ambulatory electrocardiographic monitoring: a comparison of ischemic changes of the ST-segment and coronary cineangiography]. / Monitorização eletrocardiográfica ambulatorial: comparação entre alterações isquêmicas do segmento ST e a cinecoronariografia.

PURPOSE: To determine the usefulness of an ambulatory electrocardiographic monitoring system, in identifying atherosclerotic coronary artery disease among symptomatic and asymptomatic patients, through a comparison of ST-segment depression with angiographic findings. METHODS: Fifty patients, 48 men, with the mean age 49 +/- 13 years (range 20 to 73), presenting ST-segment depression, were submitted to coronary angiography, complemented by echocardiogram and exercise testing, when the angiography was considered normal. According to the symptoms patients were divided into three groups: I--asymptomatic (16-32%); II--atypical chest pain (15-30%); and III--angina (19-38%). The Cardiac Care Units (Compass TM) system was used for the ambulatory electrocardiographic monitoring. RESULTS: Twenty-four patients (48%) had significant atherosclerotic coronary artery disease documented angiographically. Twenty-six patients (52%) had normal coronary arteries by angiography: 18 (36%), presented some pathology demonstrated by echocardiographic studies (left ventricle hypertrophy, mitral valve prolapse, non-obstructive septal hypertrophy, dilated cardiomyopathy). Eight patients (16%) had normal echocardiograms, and in (6%) the exercise test was positive and in the other 5 (6%) negative. One of those patients (2%), with negative exercise test, had a myocardial bridge over the anterior descending branch of the left coronary artery, 2 patients (4%) presented symptomatic episodes of ST depression, and 2 other patients (4%) were asymptomatic. CONCLUSION: A comparison of the ST depression analysed in real time during ambulatory electrocardiographic monitoring with the cinecoronarographic findings showed a poor correlation of the two methods in identifying atherosclerotic coronary disease. The ischemic depressions of ST-segment were associated to obstructive lesions or slow flow in the coronary arteries in only 48% of the cases studied.

[The mitral valve apparatus: an anatomo-echocardiographic approach]. / Aparelho valvar mitral: um enfoque anátomo-ecocardiográfico.

The shape of the mitral valve ring, the position of its chordae and of its leaflets were studied in 34 normal hearts fixed through intra-ventricular injection of tamponate formalin. As the authors have assumed that the post-rigor left ventricle has an architecture very similar to that seen at to the end of ventricular systole, comparisons were made between the anatomical and the echocardiographic features usually seen at the end of the phase of the cardiac cycle. The mitral ring has the shape of a hyperbolic paraboloid, and this peculiar geometry explains why the "apical-four chambers" view, which explores the most superficial ring segments, is the more appropriate view for detecting mitral valve prolapses. In that incidence the valvar diameter is longer (2.43 +/- 0.45 cm) that in the "parasternal view" (1.99 +/- 0.45 cm) and the angle made by the leaflets is comparatively less acute ("four chambers" = 127.41 +/- 16.45 degrees; "parasternal" = 102.05 +/- 0.17 degrees). In the "four chamber" view the point of coaptation (which represents the vertex of the referred angle) is 0.45 +/- 0.17 cm far from the echographic line usually taken as the valvar plane (EVPL-echocardiographic valvar plane line) whereas in the other view, it is more distant from this line (0.59 +/- 0.16 cm). These two last factors make both leaflets closer to the left atrium and explains why mitral valve prolapse, when present, is more easily seen in that incidence.(ABSTRACT TRUNCATED AT 250 WORDS)

Alteraçöes pulmonares pós-cirurgia cardíaca com circulaçäo extracorpórea: observaçöes sobre os pneumócitos granulosos; tipo 2 / Pulmonary changes after heart surgery with extracorporeal circulation: observations of granulous pneumocytes (type 2)

Com a finalidade de observar o efeito da circulaçäo extracorpórea sobre os pneumócitos granulosos (Tipo 2), foram estudados 22 doentes submentidos a cirurgia cardíaca. Observamos, â microscopia eletrônica, alteraçöes degenerativas progressivas com o tempo de perfusäo

Um anestesiologista no projeto "Orbis" / An anesthesiologist in the \"Orbis\" project

Descreve-se a sua experiência como anestesiologista responsável pelo Projeto Orbis, durante a sua viagem de Montego Bay até Mondevidéo, num período de dois meses, julho e agosto de 1983. Aproximadamente 200 pacientes foram operados nesta missäo, com procedimentos variando desde transplantes de córnea até vitrectomias, lensectomias com implantes de lente e extraçäo simples de cataratas. Todas as cirurgias foram filmadas (video-taped) e transmitidas simultaneamente para um auditório situado fora do aviäo e para a sala de conferências, dentro do DC-8. A assistência era constituida de médicos, enfermeiras, estudantes de medicina e parentes dos operados. Felizmente näo ocorreu nehum acidente a lamentar nesse período e a experiência foi muito válida, especialmente para a nossa compreensäo dos problemas e dificuldades com que se defrontam os cirurgiöes no mais diversos tipos de procedimento que realiza

Ultra-estrutura pulmonar e circulacao extracorporea. / Pulmonary ultrastructure and extra-corporal circulation

Com a finalidade de observar o efeito da circulacao extracorporea sobre a ultra-estrutura pulmonar, foram estudados 12 doentes submetidos a cirurgia cardiaca, com um tempo de perfusao de ate 60 minutos. Nao observamos, a microscopia eletronica, as alteracoes degenerativas classicas descritas na literatura

Infarto do miocárdio provocado por ponte miocárdica. Apresentação de um caso / Myocardial infarction caused by myocardial bridge. Report of a case

Os autores apresentam o caso de um paciente com infarto do miocardio, expresso por dor precordial, alteracoes no eletrocardiograma e nas enzimas sericas, com evidencia de ponte miocardica no estudo cinecoronariografico. Depois da ressecao cirurgica da ponte miocardica, desapareceu a dor precordial e reduziram-se as alteracoes eletrocardiograficas. Comentam a frequente associacao de ponte miocardica e miocardiopatia hipertrofica, sugerindo que podem fazer parte da mesma doenca. Salientam que a capacidade da ponte miocardica produzir isquemia depende nao so do grau de contriccao arterial, mas tambem da extensao do segmento vascular comprimido, variavel, conforme o paciente

"Atrioseptoplastia" para a correção de comunicação interatrial do tipo seio venoso com drenagem anômala de veia pulmonar em cava superior / Atrioseptoplasty for correction of interatrial defect of the venous sinus type with anomalous drainage of pulmonary vein in the superior vena cava

Descreve-se a tecnica da "atrioseptoplastia" para a correcao da comunicacao interatrial do tipo seio venoso com drenagem anomala de veia pulmonar em cava superior.Um retalho de parede anterior do atrio direito e utilizado para fechar o defeito septal desviando, simultaneamente, o fluxo da veia pulmonar para o atrio esquerdo. Um retalho de pericardio com tamanho e forma adequados e empregado para reconstruir o atrio de pericardio com tamanho e forma adequados e empregado para reconstruir o atrio direito e a veia cava superior. Dois pacientes portadores deste tipo de anomalia congenita foram operados por esta tecnica. Os resultados imediatos foram satisfatorios. Ressalta-se a simplicidade do procedimento e a facilidade de sua execucao

Injecao de morfina no espaco peridural para o tratamento de dores incoerciveis. / Injection of morphine into peridural space for treatment of incoercible pains

Baseados nas publicacoes de M. Behar e autores, sugerindo o uso de cloridrato de morfina em pequenas doses, no espaco peridural para o tratamento de dores incoerciveis, os autores utilizaram o metodo em 5 casos de neoplasias, com bons resultados

Experiencia clinica com o naloxone HCl (Narcan) em anestesia. / Clinical trial with naloxone HCl (Narcan) in anesthesia

Afim de observar o efeito do cloridrato de naloxone (NARCAN) na reversao de depressao respiratoria causada pelo fentanil, aquela droga foi empregada em 50 pacientes, escolhidos ao acaso, que se submeteram a cirrurgias diversas com duracao entre 55 minutos e 6 horas. As idades variaram de 19 a 76 anos, sendo 14 pacientes do sexo masculino e 36 do feminino, com estados fisicos classificados de I a IV (ASA). O fentanil foi utilizado na dose de 10 a 15 microgramas por quilo foi utilizado na dose de 10 a 15 microgramas por quilo por hora e, apos a descurarizacao com atropina e prostigmine, 0,1 mg de naloxone foi administrado por via venosa, repetindo-se a mesma dose a intervalos de 3 minutos quando julgado necessario, de acordo com os indices de ventilometria. Neste estudo, o naloxone mostrou ser uma droga potente, de facil manuseio e util na reversao da depressao respiratoria causada pelas grandes doses de fentanil empregadas