008), but overall survival did not differ between the groups (HR

008), but overall survival did not differ between the groups (HR 0.968; 95 % CI 0.267-3.507; p = 0.960).

We found that, compared with DES, CABG showed significantly better MACCE-free survival in chronic hemodialysis patients.”
“Cobalt ferrite nanoparticles (size: 26 +/- 4 nm) have been synthesized by coprecipitation route. The coercivity of nanoparticles follows a simple model of thermal activation of particle moments over the anisotropy barrier in the temperature range of 30-300 K in accordance with https://www.selleckchem.com/products/KU-55933.html Kneller’s law; however, at low temperatures (< 30 K), the coercivity shows some deviation from this law. The saturation magnetization follows the modified Bloch’s law in the temperature range

of 10-300 K. Exchange bias (H(ex)) studies of the samples show that H(ex) increases with decreasing temperature of the sample. A strong increase in the H(ex) values is found below 30 K for the low applied field (+/- 20 kOe), while a smaller increase is found for the high applied field (+/- BAY 80-6946 cell line 90 kOe). The slow increase in the exchange

bias at high applied field has been attributed to the high field effects on the surface (shell) spins. These shell spins align along the field direction that weakens the core-shell interface interactions leading to the reduction in the exchange bias at lower temperatures. (C) 2009 American Institute of Physics. [DOI: 10.1063/1.3139293]“
“BACKGROUND Infiltration anesthesia of the skin is an analgesic procedure often practiced before minor surgical interventions or punctures. The addition of hyaluronidase is a possible option to improve the effectiveness of the local anesthetic with respect to expansion of effect. OBJECTIVE To validate the safety of intracutaneous application of hyaluronidase as a lidocaine adjuvant. MATERIALS AND METHODS The influence of adjuvant hyaluronidase on wound healing was investigated using the suction blister method in a prospective, single-center, placebo-controlled, double-blind, intraindividual comparison study with 20 participants. Selleckchem EX 527 The target parameters were defined as the time of normalization of transepidermal water loss, hemovascular perfusion, and complete macroscopic epithelization of the wound. RESULTS No evidence was

found that adjuvant application of hyaluronidase retards wound healing. CONCLUSION The addition of hyaluronidase to lidocaine in intracutaneous infiltration analgesia does not lead to retardation of wound healing, and no additional relevant risks were observed.”
“We examined a total of 1014 patients over 18 years of age; 252 with urethritis and 762 with chronic prostatitis syndrome. The mean age of patients with urethritis was 32.7 and with prostatitis syndrome 37.6 years. Clinical symptoms of urethritis were present from a few days to several months. In patients with chronic prostatitis syndrome, symptoms were present for at least 3 months. Chlamydia trachomatis alone was confirmed in 26 (10%) and in combination with Ureaplasma urealyticum in 6 (2%) patients with urethritis.

New software workflows (i e , the step-by-step progression throug

New software workflows (i.e., the step-by-step progression through various screens in the software program during a computer-guided procedure) specific to individual procedures and implants may hasten adoption of these techniques.”
“Pseudomyogenic hemangioendothelioma is a recently described vascular tumor that occurs predominantly in the distal extremities of young adults. Because of multifocal presentation, epithelioid morphology, and strong NVP-AUY922 cytokeratin expression, the tumor was frequently misdiagnosed as epithelioid sarcoma. However, substantial immunohistochemical studies revealed an endothelial nature. It has been currently considered a tumor

of intermediate malignancy with frequent local recurrence but low risk of distant metastasis. BTSA1 ic50 In this report, we describe a case of pseudomyogenic hemangioendothelioma occurring in a 22-year-old man who

presented with multifocal disease in the lower extremity and developed bilateral pulmonary metastases within a short period.”
“Dynamic progress in the basic sciences such as clinical chemistry exerted a great influence on the development of clinical science in medicine in the 19th century. We should rate Prof. Leon Marchlewski among the group of prominent foreign and Polish scientists working in that period. Marchlewski was born in 1869 in Wloclawek, Poland. He began his chemical studies in Warsaw and then continued at the Zurich Technical University. After having graduated, he began working in the famous Edward Schunk’s laboratory in Kersal near Manchester in England. At that time he achieved recognition for his research on the chemical affinity of dyes of the animal SBC-115076 nmr and plant world. Later he cooperated in this field with another great scholar Marceli Nencki. In 1900 he returned to Poland, and in 1906 he took charge

of the Department of Medical Chemistry at Jagiellonian University. He was nominated for the Nobel Prize twice in 1913 and 1914 for his numerous achievements in the field of clinical chemistry. He took many positions at Jagiellonian University in Krakow, including dean and rector. In 1930-1935 he was a senator of the Republic of Poland. He died in 1946 in Krakow.”
“Measuring knee biomechanics in six degrees of freedom with acceptable accuracy has been proven to be technically challenging. At our bioengineering laboratory, we have employed both an in vitro robotic testing system and an in vivo combined dual fluoroscopic and magnetic resonance imaging technique to analyze the impact of anterior cruciate ligament rupture on the knee joint.

When measuring the tibiofemoral kinematics of nine cadavers with the robotic testing system, we found that anterior cruciate ligament deficiency not only altered anterior translation and axial rotation of the tibia, but it also increased the medial translation of the tibia as well.

This creates opportunities for new trials that incorporate SABR a

This creates opportunities for new trials that incorporate SABR and patient-specific systemic strategies. This selective mini-review focuses on the emerging role of SABR in patients with early-stage and oligometastatic NSCLC.”
“Scale up studies for production of lipoic acid (LA) from Saccharomyces cerevisiae have been reported in this paper for the first time. LA production in batch mode was carried out in a stirred tank bioreactor at varying agitation and aeration with maximum LA production of 512 mg/L obtained at 350 rpm and 25 % dissolved oxygen in batch culture conditions. Thus, LA production increased from 352 mg/L in shake flask to 512 mg/L in batch mode

in a 5 L stirred tank bioreactor. Biomass production under these conditions was mathematically explained using logistic equation and data obtained for LA production and substrate utilization were ML323 cell line successfully fitted using Luedeking-Piret and Mercier’s models. The kinetic studies showed LA production to be growth associated. Further enhancement of LA production was carried out using fed-batch (variable volume) and semi-continuous modes of fermentation. Semi-continuous fermentation with three feeding cycles of

sucrose selleck kinase inhibitor effectively increased the production of LA from 512 to 725 mg/L.”
“Background Surgery is the fundamental curative option for gastric cancer patients. Imaging scans are routinely prescribed in an attempt to stage the disease prior to surgery. Consequently, the correlation between radiology exams and pathology is crucial for appropriate treatment planning.

Methods Systematic searches were conducted Nocodazole supplier using Medline, Embase, and the Cochrane Central Register of Controlled Trials from January 1, 1998 to December 1, 2009. We calculated the accuracy, overstaging rate, understaging rate, Kappa statistic, sensitivity, and specificity for abdominal ultrasound (AUS), computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography

(PET) with respect to the gold standard (pathology). We also compared the performance of CT by detector number and image type. A meta-analysis was performed.

Results For pre-operative T staging MRI scans had better performance accuracy than CT and AUS; CT scanners using >= 4 detectors and multi-planar reformatted (MPR) images had higher staging performances than scanners with <4 detectors and axial images only. For pre-operative N staging PET had the lowest sensitivity, but the highest specificity among modalities; CT performance did not significantly differ by detector number or addition of MPR images. For pre-operative M staging performance did not significantly differ by modality, detector number, or MPR images.

Conclusions The agreement between pre-operative TNM staging by imaging scans and post-operative staging by pathology is not perfect and may affect treatment decisions.

A 6-run uniform design was used to investigate five factors Unde

A 6-run uniform design was used to investigate five factors. Under the best operating conditions among

the six runs, 29.0 g L-1 EPS was produced at 102 h. This condition was used as the starting point for further investigation on the two statistically significant factors, the pH and the agitation speed. An 8-run 3-level custom design that investigates up to second-order effects was used in the second stage. An optimal zone of operating conditions for large quantity of high MW pullulan production was identified. A concentration of 23.3 g L-1 EPS was produced at 78 h. This is equivalent to an EPS productivity of 0.30 g L-1 h(-1). The corresponding apparent viscosity of the broth was 0.38 Pa s at the shear rate of 10 s(-1).”
“Objective:

The purpose of this study was to provide a description of the language and speech (intelligibility, voice, DZNeP resonance, articulation) in a 7-year-old Dutch speaking boy with Nager syndrome. To reveal these features comparison CT99021 inhibitor was made with an age and gender related child with a similar palatal or hearing problem.

Methods: language was tested with an age appropriate language test namely the Dutch version of the Clinical Evaluation of Language Fundamentals. Regarding articulation a phonetic inventory, phonetic analysis and phonological process analysis was performed. A nominal scale with four categories was used to judge the overall speech intelligibility. A voice and resonance assessment included a videolaryngostroboscopy, a perceptual evaluation, acoustic analysis and nasometry.

Results: The most striking communication problems in this child were expressive and receptive language delay, moderately impaired speech intelligibility, the presence of phonetic and phonological disorders, resonance disorders and a high-pitched voice. The explanation

for this pattern of communication is not completely straightforward. The language and the phonological impairment, only present in the child with the Nager syndrome, are not part of a more general developmental delay. The resonance disorders can be related to the cleft palate, but were not present in the child with the isolated cleft palate. One might assume that the cul-de-sac resonance and the much decreased mandibular movement and the restricted tongue lifting are caused selleck kinase inhibitor by the restricted jaw mobility and micrognathia. To what extent the suggested mandibular distraction osteogenesis in early childhood allows increased mandibular movement and better speech outcome with increased oral resonance is subject for further research.

Conclusion: According to the results of this study the speech and language management must be focused on receptive and expressive language skills and linguistic conceptualization, correct phonetic placement and the modification of hypernasality and nasal emission. (c) 2010 Elsevier Ireland Ltd. All rights reserved.”
“Mediastinal abscess is a rare presentation of infections involving the mediastinum.

Methods A FE model of intact C2-C7 segments was developed and va

Methods. A FE model of intact C2-C7 segments was developed and validated. www.selleckchem.com/products/pi3k-hdac-inhibitor-i.html Fixed-core (Prodisc-C, Synthes) and mobile-core (Mobi-C, LDR Spine) artificial disc prostheses were integrated at the C5-C6 segment into the validated FE model. All models were subjected to a follower load of 50 N and a moment of 1 Nm in flexion-extension, lateral bending, and axial torsion. The range of segmental motion (ROM), facet joint force, tension on major ligaments, and stress on the polyethylene (PE) cores were analyzed.

Results. The ROM in the intact segments

after ADR was not significantly different from those of the normal cervical spine model. The ROM in the implanted segment (C5-C6) increased during flexion (19% for fixed and 33% for mobile core), extension (48% for fixed and 56% for mobile core), lateral bending (28% for fixed and 35% for mobile core) and axial torsion (45% for fixed and 105% for mobile core). The facet joint selleck screening library force increased by 210% in both fixed and mobile core models during extension and the tension increased (range, 66%-166%) in all ligaments during flexion. The peak stress on a PE core was greater

than the yield stress (51 MPa for fixed and 36 MPa for mobile core).

Conclusion. The results of our study presented an increase in ROM, facet joint force, and ligament tension at the ADR segments. The mobile-core model showed a higher increase in segmental motion, facet force, and ligament tension, but lower stress on the PE core than the fixed-core model.”
“Point mutations resulting in the substitution of a single amino acid can cause severe functional consequences, but can also be completely harmless. Understanding what determines Rapamycin purchase the phenotypical impact is important both for planning targeted mutation experiments in the laboratory and for analyzing naturally occurring mutations found in patients. Common wisdom suggests using the extent of evolutionary conservation of a residue or a

sequence motif as an indicator of its functional importance and thus vulnerability in case of mutation. In this work, we put forward the hypothesis that in addition to conservation, co-evolution of residues in a protein influences the likelihood of a residue to be functionally important and thus associated with disease. While the basic idea of a relation between co-evolution and functional sites has been explored before, we have conducted the first systematic and comprehensive analysis of point mutations causing disease in humans with respect to correlated mutations. We included 14,211 distinct positions with known disease-causing point mutations in 1,153 human proteins in our analysis. Our data show that (1) correlated positions are significantly more likely to be disease-associated than expected by chance, and that (2) this signal cannot be explained by conservation patterns of individual sequence positions.

Strong PL emission from Eu3+ ions was only observed at low temper

Strong PL emission from Eu3+ ions was only observed at low temperatures, and was remarkably suppressed with increasing GSI-IX research buy temperature due to two types of nonradiative energy transfer paths. For the energy transfer process to Eu3+ ions, we suggest that the recombination energy of an electron-hole pair at the band tail near the band edge is close to that of high-lying excited levels in the Eu3+

4f shell, providing an efficient energy pathway for the excitation of Eu3+ ions in the ZnO system. (C) 2011 American Institute of Physics. [doi:10.1063/1.3549633]“
“Adipose tissue plays an essential role in energy homeostasis as a metabolic and endocrine organ. Accordingly, adipocytes are emerging as a major drug target for obesity and obesity-mediated metabolic syndrome. Dysfunction of enlarged adipocytes in obesity is involved in obesity-mediated metabolic syndrome. Adipocytokines, such as adiponectin released from small adipocytes, are able to prevent these disorders. In this study, we found that honokiol, an ingredient of Magnolia officinalis used in traditional Chinese and Japanese medicines, enhanced adipocyte

differentiation in 3T3-L1 preadipocytes. Oil Red O staining showed that treatment with honokiol in the presence of insulin dose-dependently increased lipid accumulation in 3T3-L1 preadipoyctes although its activity was weak compared with rosiglitazone. PP2 During adipocyte differentiation, the expression of peroxisome proliferator-activated receptor gamma 2 (PPAR gamma 2) mRNA and PPAR gamma target genes such as adipocyte protein 2 (aP2), adiponectin, and GLUT4 was induced

by treatment with 10 mu M honokiol. However, honokiol failed to show direct binding to the PPAR gamma ligand-binding domain in vitro. In preadipocytes, treatment with honokiol in the presence of insulin increased the phosphorylation of extracellular signal-regulated learn more kinase (ERK) 1/2 protein and Akt protein, early insulin signaling pathways related to adipocyte differentiation, compared with insulin-only treatment. Taken together, our results suggest that honokiol promotes adipocyte differentiation through increased expression of PPAR gamma 2 mRNA and potentiation of insulin signaling pathways such as the Ras/ERK1/2 and phosphoinositide-3-kinase (PI3K)/Akt signaling pathways.”
“Background: A specific diagnostic test for Kawasaki disease (KD) is currently unavailable. Redness or crust formation at the Bacille Calmette-Guerin (BCG) inoculation site is listed as a positive sign in the diagnostic guidelines of KD. The purpose of this study was to investigate the epidemiologic features of KD patients with such changes at the BCG inoculation site and to evaluate the specificity of this sign in KD diagnosis.

Methods: Data on KD patients who received BCG vaccination were analyzed from a Japanese nationwide epidemiologic survey on KD conducted in 2007.

The high impact of

The high impact of SHP099 price asthma found in this Caracas slum underscores the realities of Venezuela’s impoverished urban majority. To properly address this important challenge, our National Asthma Control Program needs to be reassessed.”
“Objective: To evaluate the histopathology of the temporal bones of a patient with documented superficial siderosis of the central nervous system who underwent

right cochlear implantation six years before death.

Background: Superficial siderosis of the central nervous system is due to chronic or repeated subarachnoid hemorrhage and results in sensorineural deafness in 95% of affected individuals in addition to other neurologic findings. The deposition of hemosiderin in the meninges and around

cranial nerves is thought to be causative. There have been no previous reports of temporal bone pathology in this disorder. This 57 year old man developed progressive, bilateral hearing loss starting in his 30′s with loss of pure tone thresholds and word recognition. He underwent a right cochlear implant at age 51 with full insertion of the device.

Methods: The temporal bones and brainstem were fixed in formalin and prepared for histologic study by standard techniques. Special stains, including Gomori stain for iron were performed INCB028050 concentration on sections of the temporal bones and cochlear nucleus.

Results: There was severe bilateral degeneration of the organ of Corti, spiral ligament, stria vascularis, and spiral ganglion cells. Gomori stain revealed iron deposits within the spiral GSK1838705A chemical structure ligament, stria vascularis and in the subepithelial mesenchymal tissue of the maculae of the vestibular system. Evaluation of the cochlear

nucleus revealed iron deposits within glial cells and larger cells, probably macrophages, near the CSF surface. On the right side, the track created by the cochlear implant entered the scala tympani and continued to mm17, as measured from the round window.

Discussion and Conclusion: This is the first known case of superficial siderosis with documented temporal bone histopathology. Hearing loss was likely caused by severe degeneration of spiral ganglion cells in both ears, despite the presence of remaining hair cells in the middle and apical turns. This was consistent with cochlear neuronal degeneration and retrograde degeneration of spiral ganglion cells within the inner ear, or alternatively, consistent with primary degeneration of hair cells and neural structures within the cochlea. Despite the presence of neural degeneration, the patient achieved a word recognition score of 28% six months following implantation.”
“The treatment of IBD with anti-TNF agents has substantially evolved since their first introduction more than a decade ago. The robust efficacy witnessed in many patients has raised new questions pertaining to the observation of subgroups of patients who fail to respond or who lose response to these otherwise very effective drugs.

The results show that KH possesses the highest water absorption m

The results show that KH possesses the highest water absorption multiplying FK228 solubility dmso factor and HLM possesses the lowest one. Under

the condition of repeated water absorption and water release, the structure of FILM hydrogel transfers from gridding membrane to network structure. Various types of cation solutions significantly affect the characteristics of micromorphology of HLM hydrogel, and both uniqueness and diversity prevail. Under the condition of repeated water absorption and water release, the swelling multiplying factor of HLM in deionized water abides by an “”inverted U”" distribution. The water absorption multiplying factor for the third time is the largest one. This is primarily caused by both reduction of resilience of crosslinking network and dissolution of polymer on the surface of hydrogel under the condition of repeated water absorption and water release. The boundary of hydrogel pore network of the three types of SAPs possesses fractal characteristics. The number of fractal dimensions

is as follows: fractal dimension of HLM < fractal dimension of AS < fractal dimension of KH. With the increase of the number of repeated water absorption and water release, the number of fractal dimensions of cross-sectional pore boundary reduces, that is, T1 (1.3848) > T3 (1.2100) > T5 (1.1226). (C) 2009 Wiley Periodicals, Inc. J Appl Polym Sci 113: 3510-3519, 2009″
“A 2-year-old girl with AZD1480 supplier tetralogy of Fallot presented with diffuse cranial infarct after cardiac angiography. Heterozygosity for factor V Leiden and prothrombin 20210A mutations were detected. The authors suggest that if thrombosis develops www.selleckchem.com/products/10058-f4.html in patients with congenital heart disease, genetic risk factors should be evaluated.”
“Although poly(ethylene terephthalate) (PET) has excellent basic properties, this polymer tends to crystallize rapidly and has a rather high melting temperature, a low glass-transition temperature, and low impact on notched articles for some potential applications. Copolymerization is a reasonable method for improving the properties of PET.

1,4-cyclohexane dimethanol (CHDM) is one of the most important comonomers for PET. In this research, PET and PET copolymers containing 5-30% CHDM were prepared from comonomer mixtures by two-step melt polycondensation. The copolymers were synthesized in a homemade laboratory setup. The first synthesis step was conducted under pressure, and the second was performed in vacuo at a high temperature (230-290 degrees C). The microstructure of the synthesized copolymers was studied with Fourier transform infrared and nuclear magnetic resonance. The comonomer content in the polymer chain was determined from the nuclear magnetic resonance spectrum. The presence of the comonomer in the copolymer chain was random.

Therefore, A heterophyllus seed provides future opportunities in

Therefore, A. heterophyllus seed provides future opportunities in nanomedicine by tagging nanoparticles with jacalin. (c) 2013 Elsevier B.V. All rights reserved.”
“Two new dibenzocyclooctadiene lignans, schinegllignans A and B (1 and 2), together with 11 Selleck BTK inhibitor known (3 13) were isolated from the fruit of Schisandra neglecta. Their structures and stereochemistries were elucidated by spectroscopic methods, including 1D, 2D NMR, and HR-ESI-MS techniques. Compounds 1 and 2 were evaluated for their anti-HIV activities, and they showed moderate anti-HIV-1 activities with therapeutic index values of 18.5 and 24.6.”
“Objective:

Determine whether more conservative management for surgical salvage after failed radiation leads to better facial nerve outcomes.

Study Design: “”Retrospective” VE821 review using prospectively planned database.

Setting: Private practice, tertiary neurotology/neurosurgery referral center.

Patients: A series of 73 patients with vestibular schwannoma, who underwent primary radiosurgery with no other intervention and then surgical salvage tumor removal using the translabyrinthine approach.

Intervention(s): Translabyrinthine craniotomy for vestibular schwannoma

salvage surgery after failed radiation, with either gross total or partial tumor removal.

Main OutcomeMeasures: Long-term (1 yr) House-Brackmann (H-B) facial nerve grade and change in facial nerve grade from before to after surgery.

Results: Of Cytoskeletal Signaling inhibitor the 73 patients, 79.5% had gross total removal, 5.5% had planned partial resection (subtotal or near total), and 15.1% had intraoperatively

elected partial removal with most of these being near total removal. At 1 year of follow-up, good facial nerve function (H-B I/II) was found in 50% of patients with gross total removal and 85.7% of those with partial removal (p <= 0.03). The H-B grade was maintained postoperatively in 45.8% and 78.6% of the 2 groups, respectively (p <= 0.037), with 21.7% of the total removal group having unsatisfactory outcomes (H-B V or VI) compared with 7.1% of patients with partial removal. To date, no patient has required additional treatment.

Conclusion: Failed radiosurgery is an increasing indication for salvage surgery in patients with posterior fossa tumors. A conservative approach with a willingness to perform partial and near-total tumor removals leads to better facial nerve outcomes with no current evidence of treatment compromise.”
“The observed increased risks of noncardia stomach cancer among foreign-born second-generation immigrants compared to the Swedes suggest that these immigrants were infected by Helicobacter pylori before immigration.”
“The microencapsulation of gallic acid (GA) with chitosan (C), beta-cyclodextrin (beta-CDS) or xanthan (X) was prepared by the lyophilization method. The encapsulation was verified by Fourier transform infrared spectroscopy, UV-visible spectroscopy, scanning electron microscopy, differential scanning calorimetry and thermogravimetric analysis.

The pepino is highly diverse and, by using appropriate breeding s

The pepino is highly diverse and, by using appropriate breeding strategies, it has been possible to develop new improved materials. Here we review more than a decade of efforts and advancements made in the genetic improvement of the pepino for several traits, with special emphasis on fruit quality. Different strategies, like the use of

a wide diversity of genetic resources, exploitation of genotype x environment interaction, use of clonal hybrids, and introgression of genes from wild species, MK-8776 cost have facilitated significant developments in enhancing the commercial potential of the pepino, and have allowed the development of new cultivars and breeding materials adapted to new agroclimatic conditions. Agronomic performance of the pepino has been improved by the use of genetic parthenocarpy, selection for resistance to Tomato Mosaic Virus, and by developing hybrids, that manifested

heterosis, but also did not have lower quality fruit. Breeding for quality AS1842856 supplier has been focused mostly on the improvement of flavor (sweetness and aroma) and nutritional value (ascorbic acid content; AAC). Despite the limited intraspecific diversity available for sugar content, materials with high soluble solids content (SSC) have been selected. Strategies for further increases of SSC and titratable acidity have been based in the use of wild relatives. The study of variation within the cultigen was also helpful in the selection of hybrid genotypes with improved aroma profiles and high AAC values. As a result of the breeding efforts, several cultivars with improved agronomic performance and fruit quality have been produced. The use of biotechnological tools represents an opportunity to use the extensive genomic information compiled for related

species, like tomato or potato, for the future improvement and enhancement of pepino quality. The results obtained in the pepino show that ample opportunities exist for improving the commercial potential of under-utilized fruits by means of breeding based on the exploitation of genetic diversity. (C) 2010 Elsevier Ltd. All rights reserved.”
“Introduction. Halogenated anesthetics can cause changes in the variables that modify the cardiac output necessary to maintain renal hemodynamic during hemorrhagic shock and resuscitation. However, halogenated Selleckchem ABT-263 anesthetics seem to protect against renal ischemia-reperfusion injury. In a model of pressure-guided hemorrhagic shock in dogs, we studied the comparative effects of three halogenated anestheticshalothane, sevoflurane, and isofluraneat equipotent concentrations on renal responses after resuscitation. Methods. Thirty dogs were anesthetized with 1.0 minimum alveolar anesthetic concentration (MAC) of halothane, sevoflurane, or isoflurane. The dogs were splenectomized and hemorrhaged to hold mean arterial pressure at 40-50 mm Hg over 45 min and then resuscitated with the shed blood volume.