Efficacy of perfusion cooling of the epidural space and cerebrospinal fluid drainage during repair of extent I and II thoracoabdominal aneurysm.

AIM: The aim of this study was to evaluate spinal cord injury and mortality resulting from repair of extent I and II thoracoabdominal aneurysm. The authors compared patients operated under mild hypothermia with or without epidural perfusion cooling (EPC) and cerebrospinal fluid drainage (CSFD). METHODS: From 1988 to 2007, 116 patients underwent replacement of the thoracoabdominal aorta; the procedure was performed in 38 patients with the aid of mild hypothermia alone (group A), and in 78 patients with the aid of EPC, mild hypothermia and CSFD (group B). Two catheters for epidural perfusion cooling were inserted in group B, in which one catheter was inserted into the epidural space to infuse chilled saline, and the other was inserted into the subdural space to drain the cerebrospinal fluid and to measure temperature and pressure. There were no significant differences in mean age, etiology of aortic disease, and aneurysm extent between the two groups. RESULTS: There were no significant differences in cardiopulmonary bypass time, the lowest nasopharyngeal temperature and operation time between the two study groups. The incidence of spinal cord injury in group A (16.2%) was significantly higher than in group B (3.8%, P=0.03). Hospital mortality in groups A and B was 10.5% and 2.6%, respectively (P=0.08). There was no significant difference in postoperative complications between the two study groups. CONCLUSION: The combination of EPC and CSFD was effective in lowering the incidence of postoperative spinal cord injury in the repair of extent I and II thoracoabdominal aortic aneurysm.

Endovascular repair of a descending thoracic aortic aneurysm: a tip for systemic pressure reduction.

A proposed technique for systemic pressure reduction during deployment of a stent graft was studied. A 67-year-old man, who had a descending thoracic aneurysm, was successfully treated with an endovascular procedure. An occluding balloon was introduced into the inferior vena cava (IVC) through the femoral vein. The balloon volume was manipulated with carbon dioxide gas to reduce the venous return, resulting in a transient and well-controlled hypotension. This IVC-occluding technique for systemic pressure reduction may be safe and convenient to minimize distal migration of stent grafts.

Comparative study of maize cultivars 30 days after pollination (30 DAP): carbohydrates and protein.

A comparative study of the carbohydrates and protein of five maize cultivars at 30 days after pollination (DAP) showed a higher protein content for the Supersweet variety, and better protein quality for the Maya Opaque-2, Nutrimaiz, the Supersweet, and the Hybrid L90 x L41, when compared to the Maya Normal. The lipid content also proved to be higher in the four genetically-modified cultivars in relation to the Maya Normal. In contrast, the Maya Normal and the Opaque-2 were higher in starch content, lower in total and reducing soluble sugars, and exhibited only very small amounts (approximately equal to 1%) of phytoglycogen, a water-soluble polysaccharide. Nutrimaiz and the Hybrid L90 x L41 had approximately half the starch of the Maya Normal cultivar, but presented an appreciable content of phytoglycogen (23-26%), which is typical for sugary maize mutants, and a higher amount of soluble sugars, mainly sucrose, in relation to Maya Normal. The Supersweet had about half the starch content and a very high (approximately equal to 24%) amount of soluble sugars, mainly sucrose, in relation to the Maya Normal cultivar. The Supersweet also had a negligible amount of phytoglycogen. Nutrimaiz and the Hybrid L90 x L41 showed a much higher proportion of grain in the ears and, as a consequence, a higher yield of dry solids at 30 DAP, when compared with the Maya Normal cultivar.